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Verbogener elastischer Titannagel bei Klavikulapseudarthrose

Fallbericht mit Literaturübersicht

Bent titanium elastic nail in clavicular non-union

Case report and review of the literature

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Zusammenfassung

Klavikulafrakturen können in vielen Fällen konservativ behandelt werden. Bei stark dislozierten einfachen Frakturformen, bei denen sich ein konservatives Vorgehen nicht bewährt hat, stellt die intramedulläre Nagelung mit einem elastischen Titannagel („titanium elastic nail“, TEN) mittlerweile ein ebenbürtiges Behandlungsverfahren zur stabilen Plattenosteosynthese dar. Im vorgestellten Fall berichten wir über eine 28-jährige Patientin mit vor 4 Jahren auswärtig durchgeführter TEN-Osteosynthese. Im Verlauf kam es bei erneutem Trauma und bereits bekannter Klavikulapseudarthrose zu einer Verbiegung des TEN sowie zur Nagelmigration in das Manubrium sterni. Wir schildern das operative Vorgehen zur Nagelentfernung. Nagelverbiegungen nach TEN-Implantation sowie Nagelmigrationen sind Komplikationen, worüber Patienten aufgeklärt werden sollten und weshalb der Nagel nach 3 bis 12 Monaten und stattgehabter Frakturkonsolidierung auch entfernt werden sollte.

Abstract

Fractures of the clavicle can often be treated conservatively. For severely dislocated but simple fractures in which conservative treatment often fails, intramedullary nailing with titanium elastic nails (TEN) shows similar results to stable plate osteosynthesis. We present the case of a 28-year-old female patient who had been treated with TEN osteosynthesis 4 years previously but clavicular non-union developed. Due to a new traumatic incident, the implanted intramedullary titanium nail was bent and migrated into the manubrium sterni. We were able to remove the wire and stable plate osteosynthesis was carried out. Bending and migration of titanium wires used in clavicular fractures are relatively rare complications and patients must be informed accordingly. These complications can be avoided by removal of the wire 3–12 months after implantation when the fracture has healed.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Huber-Wagner, N. Harrasser, I.J. Banke, C. Kirchhoff und P. Biberthaler geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Unfallchirurgie, Überregionales Traumazentrum, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    N. Harrasser, I.J. Banke, C. Kirchhoff, P. Biberthaler &  S. Huber-Wagner

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  1. N. Harrasser
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  2. I.J. Banke
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  3. C. Kirchhoff
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  4. P. Biberthaler
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  5. S. Huber-Wagner
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Correspondence to S. Huber-Wagner.

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Harrasser, N., Banke, I., Kirchhoff, C. et al. Verbogener elastischer Titannagel bei Klavikulapseudarthrose. Unfallchirurg 118, 638–642 (2015). https://doi.org/10.1007/s00113-014-2644-x

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  • DOI: https://doi.org/10.1007/s00113-014-2644-x

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