Zusammenfassung
Die Arthrodese ist eine oft verwendete Technik zur Therapie einer Vielzahl von Erkrankungen im Fußbereich. Der häufigste Einsatz besteht bei der primären Arthrose und posttraumatischen Deformitäten. Gefürchtete Komplikationen sind die ausbleibende Fusion, Infektionen, Nervenschäden sowie zunehmender Verschleiß benachbarter Gelenke. Die höchsten Fusionsraten werden durch Einsatz moderner Osteosynthesematerialien mit Kompression des Arthrodesespalts erreicht. Die Nachbehandlung muss sich an der intraoperativ erreichten Stabilität, der Anzahl und Art der versteiften Gelenke und an der Compliance der Patienten ausrichten. Nervenschäden und Wundheilungsstörungen sind durch subtile Weichteilpräparation und intraoperative Blutungskontrolle zu vermeiden. Die Belastung benachbarter Gelenke kann durch selektive Durchführung der Arthrodese betroffener Gelenke möglichst gering gehalten werden, ist jedoch zu einem gewissen Grad unvermeidbar.
Abstract
Performing an arthrodesis is a common technique to treat multiple different foot deformities. Primary osteoarthritis and post-traumatic conditions are the most frequent indications. Various complications and reasons for failure can occur like non-union, nerve damage, wound healing disorders or adjacent joint degeneration. The highest fusion rates can be achieved by compression of the joint space using modern osteosynthesis material. Postoperative care needs to be adapted to intraoperative stability, quantity and location of the fused joints and the compliance of the patient. Nerve damage and wound healing problems can be avoided by subtle soft tissue preparation and intraoperative hemostasis. Degeneration of the adjacent joints is inherent to method but can be minimized by selective arthrodesis of only the affected joints.
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Wünschel, M. Misserfolge nach Arthrodesen am Fuß. Orthopäde 40, 407–414 (2011). https://doi.org/10.1007/s00132-010-1723-0
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DOI: https://doi.org/10.1007/s00132-010-1723-0