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Nagelung metaphysärer Frakturen

Nailing of metaphyseal fractures

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Zusammenfassung

Die Nagelung metaphysärer Frakturen verlangt eine eingehende präoperative Vorbereitung. Der Traumachirurg soll sich mit der spezifischen Morphologie der Fraktur, der individuellen Anatomie des gebrochenen Knochens sowie dem Design und den Eigenschaften des gewählten Implantats auseinandersetzen. Vor Beginn der Nagelung ist eine Reposition der Fraktur erforderlich, die während der Nagelung stabil gehalten werden muss. Die Technik der Reposition und die erforderlichen Hilfsmittel werden am besten präoperativ festgelegt. Auch soll genau darauf geachtet werden, den Nagel vorsichtig und präzise an seine korrekte Stelle zu verbringen. Erst nach erfolgreicher proximaler und distaler Verriegelung wird der Nagel der zentrale Kraftträger, der die Fraktur stabil reponiert hält. Es werden die spezifischen Probleme der Reposition und der Fixierung des Nagels bei metaphysären Frakturen des proximalen Humerus, des proximalen und distalen Femurs und der proximalen und distalen Tibia mit den hierfür erforderlichen Hilfsmitteln aufgezeigt.

Abstract

Nailing of metaphyseal fractures demands thorough preoperative planning. The trauma surgeon has to take the specific morphology of the fracture, the individual anatomy of the broken bone, and the design and characteristics of the selected implant into consideration. The fracture has to be precisely reduced and the reduction controlled during nail insertion. The reduction technique and reduction aids must be chosen preoperatively. The nail has to be introduced with care and brought to its correct and ideal position. Only after successful proximal and distal interlocking can the nail become the central weight bearing implant, which holds the fracture stable and reduced. In the following contribution, the specific problems of reduction and nail fixation of metaphyseal fractures of the proximal humerus, proximal and distal femur, and proximal and distal tibia together with the needed reduction and fixation aids are presented.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. P. M. Rommens, P. Pairon und S. Kuhn geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    P.M. Rommens, P. Pairon & S. Kuhn

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  1. P.M. Rommens
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  2. P. Pairon
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  3. S. Kuhn
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Correspondence to P.M. Rommens.

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Rommens, P., Pairon, P. & Kuhn, S. Nagelung metaphysärer Frakturen. Unfallchirurg 116, 831–846 (2013). https://doi.org/10.1007/s00113-013-2499-6

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  • DOI: https://doi.org/10.1007/s00113-013-2499-6

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