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Entfernung von Verriegelungsnägeln an der oberen und unteren Extremität

Soll diese Operation generell empfohlen werden?

Intramedullary nail removal in the upper and lower limbs

Should we recommend this operation?

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Zusammenfassung

Fragestellung

Während die Entfernung von Verriegelungsnägeln bei absoluten Indikationen (z. B. Infektionen, Implantatversagen, etc.) unbestritten ist, wird die Indikation zur Entfernung bei relativen Indikationen kontrovers diskutiert. Ziel dieser Studie war die Erhebung der Komplikationsraten.

Methode

Bei 460 Patienten, denen zwischen 1992 und 2002 ein Verriegelungsnagel aus Humerus, Femur oder Tibia entfernt worden war, wurden retrospektiv Inzidenz und Schwere von Komplikationen in Bezug auf die Indikation zur Metallentfernung analysiert.

Resultate

Die Komplikationsrate am Humerus betrug bei absoluter Indikation 29%, bei relativer Indikation 12%. Am Unterarm wurden keine Komplikationen gesehen. An Femur und Tibia waren es bei absoluter Indikation 21%, bei relativer Indikation 10%. Die häufigsten Komplikationen waren Wundheilungsstörungen und Infektionen.

Schlussfolgerung

Die elektive Verriegelungsnagelentfernung sollte aufgrund der hohen Komplikationsrate nur nach eindeutiger Indikationsstellung und sorgfältiger Evaluation durchgeführt werden.

Abstract

Background

Absolute indications for removing intramedullary locking nails (ILN) are undisputed, but there are also relative indications when implant removal might be discussed. The aim of our study was to evaluate complications of ILN removal in the upper and lower extremities.

Methods

Four hundred sixty (460) patients who underwent interlocking nail removal were reviewed regarding complications after removal of implants in the humerus, femur, or tibia.

Results

The most common complications were delayed wound healing and wound infections. For the humerus, the complication rate of implant removals due to absolute indication was 29%, and the rate for removals due to relative indication was 12%. In the forearm, no complications were seen. Patients who underwent ILN removal in the femur or tibia for absolute indication had a 21% complication rate; the complication rate in patients with relative indication was 10%.

Conclusion

The complication rate of interlocking nail removal is too high to justify such a procedure without clear indication.

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Authors and Affiliations

  1. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    K. Hora, K.P. Vorderwinkler, V. Vécsei &  C. Gäbler

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  1. K. Hora
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  2. K.P. Vorderwinkler
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  3. V. Vécsei
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  4. C. Gäbler
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Correspondence to C. Gäbler.

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Hora, K., Vorderwinkler, K., Vécsei, V. et al. Entfernung von Verriegelungsnägeln an der oberen und unteren Extremität. Unfallchirurg 111, 599–606 (2008). https://doi.org/10.1007/s00113-008-1450-8

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  • DOI: https://doi.org/10.1007/s00113-008-1450-8

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