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Korrektureingriffe am kindlichen Ober- und Unterarm

Surgical correction of the upper and lower arm of children

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Zusammenfassung

Die Ursachen posttraumatischer Deformitäten im Bereich des Ober- und Unterarmschafts sowie des gesamten Ellbogens sind in über 90% iatrogen, im Bereich des proximalen Humerus und des distalen Unterarms in ca. 90% schicksalhaft (hemmende Wachstumsstörungen). Grundsätzlich sind Korrekturen von Deformitäten in jedem Alter durchführbar, abhängig von den Beschwerden des Patienten, von der weiteren Wachstumserwartung, von der Lokalisation der Deformität und von deren Ab- oder Zunahme während des Wachstums. Die Korrekturtechnik sollte erlauben, sämtliche Komponenten der Deformität zu beseitigen, das Korrekturergebnis sicher bis zur Heilung zu retinieren und dem Patienten den Komfort der Bewegungsstabilität zu gewährleisten. Angesichts des großen Prozentsatzes an iatrogenen Deformitäten sollte eher der Optimierung der Primärtherapie Aufmerksamkeit geschenkt werden, als die Indikation zur Korrektur auszuweiten.

Abstract

The causes of post-traumatic deformities of the upper and lower arm shafts as well as the complete elbow are 90% iatrogenic, in the area of the proximal humerus and the distal lower arm they are about 90% the result of chance (premature closure of the growth plate). In general, corrections of deformities are possible at any age, dependent on the patient’s symptoms, the expected development, the location of the deformity and its changes during development. The correction technique should allow for the removal of all of the components of the deformity, and to retain the results until healing is complete and the patient’s motor stability is ensured. Due to the high percentage of iatrogenic deformities, the optimisation of the primary therapy should receive particular attention rather than increasing the indications for a correction.

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von Laer, L. Korrektureingriffe am kindlichen Ober- und Unterarm. Unfallchirurg 107, 552–562 (2004). https://doi.org/10.1007/s00113-004-0807-x

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