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Operatives Management und Frakturversorgung der unteren Extremität bei morbider Adipositas

Literaturübersicht und Erfahrungen mit dem Ilizarov-Ringfixateur

Operative management and fracture care of the lower leg with the Ilizarov fixator in morbidly obese patients

Literature review and results

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Zusammenfassung

Mit zunehmender Adipositasprävalenz wird es für Chirurgen und Krankenhäuser wichtig, mit dem operativen Management von übergewichtigen Patienten vertraut zu sein. Die genaue präoperative Evaluierung der häufig schweren Begleiterkrankungen muss ebenso bedacht werden wie spezielle peri- und postoperative Behandlungen und Anforderungen an die Krankenhauslogistik. Über die Behandlung von Patient mit morbider Adipositas mit einem BMI >50 kg/m2 ist in der Literatur noch wenig berichtet.

Neben einer Literaturübersicht über das operative Management werden Ergebnisse mit individuell angefertigten Ilizarov-Ringfixateuren bei der Frakturversorgung der unteren Extremität bei krankhaft Übergewichtigen vorgestellt. Bei allen Patienten konnte eine belastungsstabile Osteosynthese erzielt werden, wobei die schweren Begleiterkrankungen das Behandlungsergebnis limitieren können.

Abstract

Given the rising prevalence of obesity, surgeons and hospitals must become more familiar with the treatment and operative management of obese patients. Several additional pre- and postoperative considerations must be involved such as appropriate assessment of comorbidities and requirements for special equipment. There are still very few data regarding morbidly obese patients with BMIs >50 kg/m2. After a general literature review of operative management of obese patients, we report on fracture care of the lower limb in such patients with custom-made Ilizarov ring fixators. We found them suited to bear enormous weight-loading but that associated comborbidities can limit successful fracture care.

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  1. Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Universität Bochum, Bükle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland

    J. Geßmann, D. Seybold, H. Baecker, G. Muhr & M. Graf

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  1. J. Geßmann
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Geßmann, J., Seybold, D., Baecker, H. et al. Operatives Management und Frakturversorgung der unteren Extremität bei morbider Adipositas. Chirurg 80, 34–44 (2009). https://doi.org/10.1007/s00104-008-1629-0

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