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Schenkelhalsverschraubung beim alten Menschen

Die subtrochantäre Femurfraktur als schwerwiegende Komplikation

Percutaneous screw osteosynthesis of femoral neck fractures in the elderly

Subtrochanteric fractures as severe complications

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Zusammenfassung

Die perkutane kanülierte Verschraubung nichtdislozierter Schenkelhalsfrakturen ist eine etablierte Methode mit dem Vorteil der geringen Invasivität insbesondere bei älteren Patienten mit häufig begleitenden Komorbiditäten. Die Frage nach der optimalen Technik ist nach wie vor nicht abschließend geklärt. Eine besonders schwere Komplikation ist das Auftreten einer subtrochantären Femurfraktur, die in der Literatur noch sehr spärlich beschrieben ist. Aufgrund des aktuellen Auftretens dieser Komplikation in unserer Klinik haben wir unsere Patienten vom 01.04.2004 bis 30.09.2009 retrospektiv analysiert und eine Literaturrecherche durchgeführt mit besonderem Augenmerk auf die Schraubenkonfiguration und die Inzidenz subtrochantärer Femurfrakturen. In unserem Kollektiv von 35 Patienten >65 Jahre trat diese Komplikation in 2 Fällen (5,7%) auf, ohne dass ein adäquates Trauma vorlag.

Abstract

Percutaneous osteosynthesis by cannulated screws is a well established method for the treatment of non-displaced femoral neck fractures, especially in elderly patients with comorbidities due to low operative invasiveness. Optimal screw placement is still under discussion. There are only few literature references concerning the complication of subtrochanteric femoral fractures. We performed a review of the literature and a retrospective analysis of our patients treated by this form of osteosythesis from 01.04.2004 to 30.09.2009 searching for screw placement and the incidence of subtrochanteric femoral fractures. This complication was found in 2 of our 35 patients (5.7%) without adequate trauma, such as a stumble or fall having occurred.

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  1. Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland

    H. Jansen, S.P. Frey & R.H. Meffert

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  1. H. Jansen
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  2. S.P. Frey
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  3. R.H. Meffert
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Correspondence to H. Jansen.

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Jansen, H., Frey, S. & Meffert, R. Schenkelhalsverschraubung beim alten Menschen. Unfallchirurg 114, 445–451 (2011). https://doi.org/10.1007/s00113-010-1816-6

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