Zusammenfassung
Die distale Radiusfraktur ist die häufigste Fraktur des erwachsenen Menschen und macht ein Viertel aller Frakturen aus, mit steigender Inzidenz. Das Patientenaufkommen und der Anspruch an eine exakte Versorgung sind hoch. Die Weiterentwicklung diagnostischer und operativer Möglichkeiten ermöglicht in vielen Fällen eine hochwertige Versorgung mit gutem klinischem Ergebnis. Radiusfrakturen treten jedoch oft nicht isoliert, sondern in Kombination mit anderen Frakturen oder Bandverletzungen auf. Deren Häufigkeit und Ausmaß stehen mit der Komplexität der ursprünglichen Verletzung nicht im Zusammenhang. Ziel ist es, potenzielle Begleitverletzungen zu erkennen und richtig einzuschätzen. Viele Verletzungen müssen primär nicht mitversorgt werden, sondern heilen nach der Versorgung des Radius ohne zusätzliche Therapie aus. Wichtig ist es, diejenigen zu erkennen, die unbehandelt schwere Komplikationen verursachen können. Genau dies ist jedoch häufig schwierig. In vielen Fällen besteht Uneinigkeit, ob und wie eine Begleitverletzung versorgt werden sollte. Dieser Beitrag beleuchtet die häufigsten Begleitverletzungen bei distaler Radiusfraktur mit möglichen Vor- und Nachteilen einer Mitversorgung, um eine Entscheidungsfindung zur erleichtern.
Abstract
Distal radius fractures are the most common fractures in adults and account for one quarter of all fractures, with increasing incidence. The number of patients and the requirement of an exact treatment are high. Continuous developments in diagnostic and operative possibilities enable in many cases a high-quality treatment with good clinical outcome; however, radius fractures rarely occur alone but in combination with additional fractures or ligamentous injuries. The frequency and extent of these injuries are not linked to the complexity of the primary injury. The aim is to recognize and correctly diagnose potential concomitant injuries. Many injuries do not need immediate treatment but heal without additional treatment after the radius has been treated. It is important to recognize those injuries which can cause severe complications if untreated; however, exactly this is often difficult. In many cases there is still no consensus if and how concomitant injuries should be treated. This article highlights the most frequent concomitant injuries in distal radius fractures with the possible advantages and disadvantages of cotreatment in order to facilitate decision making.
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K. Megerle und S. Wieschollek sind Consultant der Fa. Newclip.
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Wieschollek, S., Megerle, K. Begleitende Verletzungen von Karpus, distaler Elle und distalem Radioulnargelenk bei distaler Radiusfraktur. Unfallchirurgie (2024). https://doi.org/10.1007/s00113-024-01424-2
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DOI: https://doi.org/10.1007/s00113-024-01424-2
Schlüsselwörter
- Handgelenkfrakturen
- Processus styloideus ulnae
- Triangulärer kartilaginärer Komplex
- Skapholunäres Ligament
- Kahnbein