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Azetabulumfrakturen

Acetabular fractures

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Zusammenfassung

Die Behandlung von Azetabulumfrakturen stellt höchste Anforderungen an Kenntnisse der knöchernen Anatomie, der Expositionsmöglichkeiten über die anzuwendenden Zugänge sowie die frakturtypabhängige Indikationsstellung. Der Frakturklassifikation kommt dabei wesentliche Bedeutung im Rahmen der präoperativen Planung und Entscheidungsfindung zu. Das Ziel der anatomischen Gelenkrekonstruktion begründet sich aus der damit verbunden hohen Rate guter Langzeitergebnisse.

Es wird die klassische Standardversorgung von Azetabulumfrakturen dargestellt. Neben relevanten anatomischen Besonderheiten, biomechanischen und pathomechanischen Überlegungen werden die wichtigen radiologischen Grundlagen und die Wahl des Behandlungsverfahrens, konservativ und operativ, sowie die Grundlagen der operativen Zugangswahl dargestellt.

Die Besonderheiten des jeweiligen Frakturtyps wie Häufigkeit, Entstehungsmechanismus, Begleitverletzungen, Möglichkeiten der konservativen und operativen Therapie, Repositionsqualität nach operativer Versorgung sowie die jeweiligen Langzeitergebnisse werden analysiert.

Zusätzlich werden die epidemiologischen Daten zu allgemeinen postoperativen Komplikationen angegeben.

Abstract

Treatment of acetabular fractures requires extensive knowledge of the bony anatomy, the amount of possible exposure of the bone with the selected approaches and fracture type-dependent indications of operative treatment. Classification of the fracture with detailed analysis of the fracture morphology is the basis for decision making and planning. The primary treatment aim is the anatomic reconstruction of the acetabulum which results in optimal long-term results.

The basis of this overview is the presentation of standard treatment concepts in acetabular fracture surgery. Beside characteristics of the acetabular bony anatomy, biomechanical and pathomechanical principles and the relevant radiological anatomy, the treatment options, both conservative and operative and basic principles of the indications for standard surgical approaches will be discussed.

The special fracture type is discussed in detail regarding incidence, injury mechanism, concomitant injuries, options for conservative and operative treatment, quality of operative reduction and long-term results.

Furthermore, epidemiological data on typical postoperative complications are evaluated.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie, Orthopädie und Neurotraumatologie, Allgemeines Krankenhaus Celle, Siemensplatz 4, 29223, Celle, Deutschland

    A. Gänsslen & H.J. Oestern

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  1. A. Gänsslen
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  2. H.J. Oestern
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Correspondence to A. Gänsslen.

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Gänsslen, A., Oestern, H. Azetabulumfrakturen. Chirurg 82, 1133–1150 (2011). https://doi.org/10.1007/s00104-011-2135-3

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