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Klavikulafrakturen

Fractures of the clavicle

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Trauma und Berufskrankheit

Zusammenfassung

Die konservative Behandlung galt viele Jahre als der Goldstandard in der Therapie der Klavikulafrakturen. Neuere Arbeiten konnten jedoch zeigen, dass neben den Heilungsschwierigkeiten bei stark dislozierten Frakturen mit Trümmerzone auch die Verkürzung entsprechende Folgen mit sich bringt. Dieser Längenunterschied bedeutet neben einem auffälligen kosmetischen Ergebnis auch eine funktionelle Störung im Ablauf der Schulterbewegung. Die Plattenosteosynthese ist mit einer größeren Narbe behaftet, führt aber zu recht guten Ergebnisse. Die Komplikationsrate ist bei entsprechender Operationstechnik gering. Die intramedulläre Schienung ist ein Verfahren, das insbesondere bei den A-Frakturen geeignet ist und sehr gute Ergebnisse in der Literatur zeigt. Vorteile sind der kleine Zugang, die rasche Schmerzreduktion und die guten funktionellen Resultate. In den meisten Arbeiten wird über eine offene Reposition von 30% berichtet.

Abstract

For many years, conservative treatment was regarded as the gold standard for fractures of the clavicle. Recent publications, however, have shown that in addition to a high nonunion rate in severe dislocated fractures with a comminution, shortening after healing is also a problem. The difference in length has cosmetic implications and also causes functional difficulties with shoulder movement. Plate osteosynthesis leaves a large scar, but gives quite good results. The complication rate is low when an appropriate surgical technique is implemented. Elastic nailing is especially suitable for the treatment of A-class fractures, and excellent results have been reported for it in the literature. Its advantages are the minimally invasive access, rapid pain attenuation and good functional results. In published studies open reduction has been reported to be necessary in 30% of casaes.

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Correspondence to H.-J. Oestern.

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Nach einem Votrag, gehalten auf der Unfallmedizinischen Tagung am 03./04.03.2006 in Hamburg.

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Oestern, HJ. Klavikulafrakturen. Trauma Berufskrankh 9, 309–314 (2007). https://doi.org/10.1007/s10039-007-1236-1

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