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Arthroskopische Knie- und Schulteroperationen

Lagerungs- und Verbrennungsschäden

Knee and shoulder arthroscopy

Positioning and thermal injuries

  • Leitthema
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Diese Arbeit befasst sich mit einem wichtigen Aspekt der Komplikationen bei Schulter- und Kniearthroskopie. Intraoperative Lagerungsschäden während dieser Eingriffe sind selten und betreffen vornehmlich periphere Nerven- und Weichteilstrukturen. Trotz der meist benignen Prognose existieren auch fatale Verläufe, die den Patienten langfristig schwerwiegend schädigen können. Die vorliegende Arbeit gibt eine Übersicht über die Häufigkeit unterschiedlicher Lagerungsschäden, deren Prävention und dem Verhalten bei erfolgtem Schaden. Die rechtlichen Hintergründe und Verantwortlichkeiten werden beleuchtet und die Bedeutung der gründlichen präoperativen Abklärung von Vorschäden und Risikofaktoren wird hervorgehoben. Zusätzlich wird das breite Spektrum möglicher thermischer Gefahrenquellen für den Patienten während der Arthroskopie durch z. B. elektrochirurgische Instrumente oder der Kaltlichtquelle aufgezeigt, sowie Vermeidungsstrategien dargelegt.

Abstract

Intraoperative positioning injuries during shoulder- and knee arthroscopy are rare complications and affect mainly nerves and soft tissue. Although the majority of these complications are reversible, in some cases serious negative consequences for the patient persist. This article describes the frequency of several positioning injuries including their prevention and the appropriate treatment. The legal responsibilities are illustrated as well as the importance of an intense preoperative investigation of preexisting diseases and possible risk factors. Furthermore, a review of possible thermal injuries of the patient during arthroscopy caused by e.g. electrosurgical instruments or the cold light source, is given as well as prevention strategies.

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  1. Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung, Marienstraße 72-90, 30171, Hannover, Deutschland

    S. Meyer & P. Lobenhoffer

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  1. S. Meyer
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  2. P. Lobenhoffer
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Correspondence to S. Meyer.

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Meyer, S., Lobenhoffer, P. Arthroskopische Knie- und Schulteroperationen. Orthopäde 37, 1056–1064 (2008). https://doi.org/10.1007/s00132-008-1308-3

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