Zusammenfassung
Die interdisziplinäre Zusammenarbeit von Orthopäden und plastischen Chirurgen ist in der rekonstruktiven Chirurgie der Extremitäten sowohl bei traumatologisch-orthopädischen Frakturen mit ausgedehnten Weichteilschäden als auch bei muskuloskeletalen Tumorresektionen indiziert. Der Beitrag stellt insbesondere die Rekonstruktionen nach Tumorresektionen dar, wobei die enge Zusammenarbeit bereits in der präoperativen Planung wichtig ist, um das gemeinsame Vorgehen unter besonderer Berücksichtigung ggf. notwendiger adjuvanter Therapien zu diskutieren. Je nach Lokalisation und Ausmaß tumorchirurgischer Resektionen stehen zur Weichteildeckung sowie zur funktionellen Rekonstruktion verschiedene Möglichkeiten zur Verfügung. Insbesondere müssen einzeitige gegenüber zweizeitigen Verfahren abgewogen werden.
Abstract
Interdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site.
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Interessenkonflikt. C. Radtke, T. Calliess, H. Windhagen und P. Vogt geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Radtke, C., Calliess, T., Windhagen, H. et al. Haut- und Weichteilkomplikationen nach tumororthopädischen Eingriffen. Chirurg 86, 234–241 (2015). https://doi.org/10.1007/s00104-014-2834-7
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DOI: https://doi.org/10.1007/s00104-014-2834-7