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Deckung unfallbedingter Weichteildefekte des Fußes

Möglichkeiten und Grenzen

Covering accident-related soft tissue defects of the foot

Possibilities and limitations

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Die Deckung unfallbedingter Weichteildefekte des Fußes stellt eine komplexe Herausforderung für den Traumatologen dar. Aufgrund der häufigen Kombinationsverletzungen ist ein interdisziplinäres Vorgehen durch ein Team aus Plastischen Chirurgen, Unfallchirurgen, Orthopädiemechanikern, Physio- und Ergotherapeuten notwendig. Verzögerte Behandlung führt zu Komplikationen und unnötigem Gewebeverlust und in der Folge zu aufwendigen Rekonstruktionen. Vor- und Rückfußdefekte erfordern eine stabile, aber schlanke Bedeckung. Dies ist oft nur durch gestielte oder freie, mikrovaskuläre Lappenplastiken möglich. Eine besondere Herausforderung stellt die Rekonstruktion der belasteten Fußsohle dar. Hier ist eine vollwertige Rekonstruktion durch Fußsohlenhaut nur selten möglich. Engmaschige Verlaufskontrollen, adäquate Schuhversorgung und Beratung bei Wund- und Fußpflege sind unabdingbar.

Abstract

Covering accident-related soft-tissue defects of the foot is a complex challenge for the traumatologist. Since there are frequently concomitant injuries, an interdisciplinary approach by a team comprising plastic surgeons, orthopedic mechanics, as well as physio- and ergotherapists is necessary. Delayed treatment leads to complications, unnecessary tissue loss and subsequently to complex reconstruction. Fore- or rear foot defects require stable but thin coverage. Reconstructing the weight-bearing plantar is a particular challenge, and full reconstruction using plantar skin is only rarely possible. Close follow-up, appropriate footwear and advice on wound and foot care are essential.

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  1. Klinik für Handchirurgie, Plastische und Mikrochirurgie, Zentrum für Schwerbrandverletzte, BG-Unfallkrankenhaus Hamburg, Bergedorfer Straße 10, 21033 , Hamburg, Deutschland

    P. Kolokythas & K. Rudolf

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  1. P. Kolokythas
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  2. K. Rudolf
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Correspondence to P. Kolokythas.

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Kolokythas, P., Rudolf, K. Deckung unfallbedingter Weichteildefekte des Fußes. Trauma Berufskrankh 11, 206–212 (2009). https://doi.org/10.1007/s10039-009-1571-5

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  • DOI: https://doi.org/10.1007/s10039-009-1571-5

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