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Implantatwahl bei trochanteren Femurfrakturen

Rolle der intramedullären Implantate

Choice of implant for trochanteric fractures of the femur

The place of intramedullary implants

  • Proximale Femurfrakturen
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Intramedulläre Implantate haben bei der Versorgung hüftgelenknaher Femurfrakturen entscheidende Vorteile: ein kleineres varisierendes Drehmoment, ein Implantat im Verlauf der Last und eine Primärstabilität sowohl bei stabilen als auch bei instabilen Frakturen. Aufgrund der ständigen Weiterentwicklung der Implantate sowie der oft nicht getrennten Betrachtung stabiler und instabiler Brüche ergeben sich aus der Literatur z. T. kontroverse Empfehlungen. Eine genaue Auswertung der Literaturdaten ergibt, dass stabile Frakturen mit jeder Technik suffizient versorgt werden können, instabile Fraktursituationen aber die Domäne der Nagelsysteme sind. Da es nicht möglich ist, eindeutig zwischen stabilen und instabilen Brüchen zu trennen, sollten alle trochanteren und subtrochanteren Femurfrakturen mit einem zephalomedullären Nagelsystem versorgt werden.

Abstract

Intramedullary implants have decisive advantages in the treatment of femoral fractures in the vicinity of the hip joint: a torque that leads to a less pronounced varus position, implantation in the course of the relevant forces, and primary stability in the case of both stable and unstable fractures. Because of the constant developments in the implants available and the frequent failure to differentiate between stable and unstable fractures, some of the recommendations in the literature seem to contradict each other. However, precise analysis of the literature data show that stable fractures can be adequately treated with any technique, while unstable fractures fall in the domain of nailing systems. Since it is not possible to distinguish unequivocally between stable and unstable fractures, all trochanteric and subtrochanteric femoral fractures should be treated with a cephalomedullary nailing system.

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Consultant Firma Zimmer Orthopedics/USA

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Correspondence to R. H. Gahr.

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Gahr, R.H. Implantatwahl bei trochanteren Femurfrakturen. Trauma Berufskrankh 9 (Suppl 1), S13–S16 (2007). https://doi.org/10.1007/s10039-005-1056-0

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  • DOI: https://doi.org/10.1007/s10039-005-1056-0

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