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Korrekturosteotomie am Humerus

Revision osteotomy of the humerus

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Operative Korrekturen posttraumatischer Veränderungen des Humerus bergen nicht unerhebliche Risiken. Die Ursachen posttraumatischer Oberarmdeformitäten sind jedoch überwiegend iatrogen und somit vermeidbar. Grundsätzlich sind Korrektureingriffe in jedem Alter möglich. Sie hängen von den Beschwerden des Patienten, der weiteren Wachstumserwartung sowie der Lokalisation der Deformität ab. Eine operative Korrektur erfordert eine umfangreiche präoperative Analyse des Ist- und Sollzustands; eine präoperative Planung ist daher in jedem Fall erforderlich. Die Korrekturtechnik sollte eine Beseitigung sämtlicher Komponenten der Deformität erlauben. Das Korrekturergebnis muss sicher bis zur Heilung retiniert werden können und sollte dem Patienten eine schmerzarme Bewegungsstabilität gewähren. Im Gegensatz zu Fehlstellungen durch schicksalhafte Wachstumsstörungen können iatrogene Deformitäten durch korrekte Repositionen beim Primäreingriff vermieden werden. Eine Korrektur bedeutet stets einen zur Primärbehandlung hinzukommenden Mehraufwand.

Abstract

Revision osteotomies for posttraumatic deformities of the humerus are associated with a high risk of complications. The majority of these deformities are caused by iatrogenic error and therefore most are preventable. In general, correction of the deformities can be performed at any age; however, this depends on the patient’s condition, as well as growth expectancy and location of the deformity. Preoperatively, extensive analysis of the actual and the nominal condition is required; therefore, preoperative planning is always required. The revision should aim to correct all components of the deformity. The result of the revision should be safely preserved until consolidation of the bone is complete, while providing the patient with low-pain stability of movement. In contrast to deformities caused by unavoidable growth disturbances, iatrogenic deformities can be avoided by means of correct reposition in the primary surgical procedure. Revision surgery always represents additional work and expense to the first treatment.

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Correspondence to S. Studier-Fischer.

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Studier-Fischer, S., Frank, C., Wagner, C. et al. Korrekturosteotomie am Humerus. Trauma Berufskrankh 10, 29–35 (2008). https://doi.org/10.1007/s10039-008-1370-4

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  • DOI: https://doi.org/10.1007/s10039-008-1370-4

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