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Frakturen des distalen Radius

Fractures of the distal radius

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Zusammenfassung

Die distale Radiusfraktur zählt zu den häufigsten knöchernen Verletzungen des Menschen. Es existieren 2 Gipfel der Prävalenz: im jugendlichen Alter um das 10. Lebensjahr sowie im mittleren Alter um das 60. Lebensjahr. Die Behandlung der Radiusfraktur ist hinsichtlich Diagnostik, Klassifikation und der zahlreichen Therapieoptionen komplex. Behandlungsziele sind die Wiederherstellung einer schmerzfreien uneingeschränkten dauerhaften Funktion des Handgelenks und die Vermeidung frakturtypischer Komplikationen. Stabile Frakturen werden in der Regel konservativ behandelt. Instabile Frakturen mit Trümmerzonen intra- und extraartikular werden zunächst geschlossen reponiert und anschließend osteosynthetisch versorgt. Die winkelstabile palmare Plattenosteosynthese hat sich in den letzten Jahren als Standardversorgung der distalen Radiusfraktur etabliert. Komplexe intraartikuläre Mehrfragmentfrakturen vom Typ C3 gemäß der Klassifikation der Arbeitsgemeinschaft Osteosynthese (AO) bedürfen einer umfassenden Diagnostik, um typische Begleitverletzungen präoperativ zu diagnostizieren und intraoperativ mitzubehandeln.

Abstract

The most prevalent fractures managed by trauma surgeons are those involving the distal radius. The injury occurs in two peaks of prevalence: the first peak around the age of 10 years and the second peak around the age of 60 years. Distal radius fracture management requires sensitive diagnostics and classification. The objectives of treatment are the reconstruction of a pain-free unlimited durable functioning of the wrist and avoidance of typical fracture complications. Non-operative conservative management is generally employed for stable non-displaced fractures of the distal radius with the expectation of a good functional outcome. Unstable comminuted fractures with intra-articular and extra-articular fragment zones are initially set in a closed operation and finally by osteosynthesis. An armament of surgical implants is available for instable fractures requiring fixation. Palmar locked plate osteosynthesis has been established in recent years as the gold standard for operative management of distal radius fractures. Complex Working Group on Osteosynthesis (AO) classification type 3 fractures require extensive preoperative diagnostics to identify and treat typical associated injuries around the wrist.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J.M. Rueger: Beratervertrag Smith & Nephew sowie Stryker. M.J. Hartel, A.H. Ruecker und M. Hoffmann 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 Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    J.M. Rueger, M.J. Hartel & M. Hoffmann

  2. Klinik für Unfall- und Widerherstellungschirurgie, Imland Klinik Rendsburg, Rendsburg, Deutschland

    A.H. Ruecker

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  1. J.M. Rueger
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  2. M.J. Hartel
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  3. A.H. Ruecker
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  4. M. Hoffmann
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Correspondence to J.M. Rueger.

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Rueger, J., Hartel, M., Ruecker, A. et al. Frakturen des distalen Radius. Unfallchirurg 117, 1025–1036 (2014). https://doi.org/10.1007/s00113-014-2676-2

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  • DOI: https://doi.org/10.1007/s00113-014-2676-2

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