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Die intramedulläre Nagelung (ESIN) von Klavikulapseudarthrosen

Ergebnisse einer prospektiven Anwendungsbeobachtung

Midshaft clavicle nonunions treated with elastic stable intramedullary nailing

Results of a prospective clinical trial

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Zusammenfassung

Das Ziel der hier vorliegenden Untersuchung bestand in der prospektiven Erhebung der Ergebnisse nach der elastisch stabilen intramedullären Nagelung von Klavikulapseudarthrosen. In einem Zeitraum von 2,5 Jahren konnten 14 Patienten in die Untersuchung einbezogen werden. Ausschlusskriterien waren Pseudarthrosen bei pathologischen Frakturen, Infektpseudarthrosen, atrophe Pseudarthrosen, knöcherne Defekte, vorausgegangene operative Maßnahmen, ein Patientenalter <18 und >70 Jahre.

Die Ergebnisse wurden nach 3, 6, 12 und 18 Monaten evaluiert. Die subjektive Schmerzempfindung, die Zufriedenheit der Patienten, der Constant- und DASH-Score waren ab dem 3. postoperativen Monat signifikant (p<0,001) besser als präoperativ. 13 Frakturen heilten innerhalb von 12 Monaten aus. Implantatdislokationen, Infekte und Refrakturen traten nicht auf.

Die elastische stabile intramedulläre Nagelung der Klavikulapseudarthrose führt ohne autologe Knochentransplantation funktionell und kosmetisch zu guten Resultaten.

Abstract

This prospective clinical trial was performed to assess healing, clinical outcome and complications after intramedullary nailing of midshaft clavicular nonunions. Over 2.5 years, 14 patients were included. Exclusion criteria were pathological fractures, bony defects, previous operative therapy, atrophic and infection pseudarthrosis and the patient’s age: <18 years or >70 years.

Results were evaluated after 3, 6, 12 and 18 months. Beginning 3 months after the operation, pain (VAS), subjective satisfaction, Constant score and DASH score were significantly better than preoperatively during the follow-up period (p<0.001). There were no infections, no implant displacements or refractures.

Intramedullary fixation of midshaft clavicular nonunions with an elastic titanium nail is a safe, minimally invasive surgical technique, producing excellent functional and cosmetic results without additional bone grafting.

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Authors and Affiliations

  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie der Universität zu Köln

    A. Jubel, J. Andermahr, G. Weißhaar, G. Schiffer, A. Prokop & K. E. Rehm

  2. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie der Universität zu Köln, Kerpener Str. 61, 50931, Köln

    A. Jubel

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  1. A. Jubel
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  2. J. Andermahr
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  6. K. E. Rehm
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Correspondence to A. Jubel.

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Jubel, A., Andermahr, J., Weißhaar, G. et al. Die intramedulläre Nagelung (ESIN) von Klavikulapseudarthrosen. Unfallchirurg 108, 544–550 (2005). https://doi.org/10.1007/s00113-005-0937-9

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