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Minor-Amputationen – eine „Maxi-Aufgabe“

Teil 2: Von der transmetatarsalen Amputation bis zur Rückfußamputation

Minor amputations – a maxi task

Part 2: From transmetatarsal amputation to hindfoot amputation

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Zusammenfassung

Maßgebliches Ziel einer Minor-Amputation ist die begrenzte Resektion mit Fuß- und Beinerhalt mit dem Gewinn – im Gegensatz zum Unterschenkelstumpf – einer voll endbelastbaren Extremität. Eine Verlagerung der Amputationshöhe im Sinne einer Verkürzung geht unweigerlich mit einer Verringerung der Standfläche, einer Zunahme des axialen Druckes und einer Störung des Muskelgleichgewichtes im Bewegungsumfang des Restfußes einher. Diese Erkenntnisse sind, neben der subtilen Behandlung der Fußsohlenhaut zwecks Deckung einer spannungsfreien Stumpfspitze, der Angelpunkt der hier weiter zu behandelnden Minor-Amputationen. Von Vorteil sind Teilamputationen in Längsrichtung bei Amputationen am Vor- und Mittelfuß.

Abstract

The definitive aim of a minor amputation is limited resection with retention of feet and legs resulting in a completely loadable extremity, in contrast to the lower leg stump. A shift in the amputation level in the sense of a shortening is inevitably accompanied by a reduction in the stand area, an increase in axial pressure and a disruption of muscle equilibrium in the extent of movement of the rest of the foot. This knowledge forms the central issue for further treatment of minor amputations in addition to the subtle treatment of the skin of the sole for coverage of a tension-free tip of the stump. Advantageous are longitudinal partial amputations of the forefoot and midfoot.

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  1. Zentrum für Gefäßmedizin und Wundbehandlung, Stiftungsklinikum Mittelrhein, Johannes-Müller-Str. 7, 56508, Koblenz, Deutschland

    R. Matamoros &  G. Riepe

  2. Klinik für Orthopädie und Unfallchirurgie (Koblenz/Boppard/Nastätten), Stiftungsklinikum Mittelrhein, Koblenz, Deutschland

    P. Drees

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  1. R. Matamoros
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  2. G. Riepe
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  3. P. Drees
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Correspondence to G. Riepe.

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Matamoros, R., Riepe, G. & Drees, P. Minor-Amputationen – eine „Maxi-Aufgabe“. Chirurg 83, 999–1012 (2012). https://doi.org/10.1007/s00104-011-2189-2

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