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Arthroskopisch gestütztes Frakturmanagement des oberen und unteren Sprunggelenks

Arthroscopy-guided fracture management of the ankle joint and calcaneus

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Einleitung

Die Frakturversorgung am oberen und unteren Sprunggelenk ist eine Domäne der offenen Gelenkchirurgie. Dennoch gibt es gute Argumente für eine differenzierte Herangehensweise und das Bestreben, ausgesuchte Frakturen arthroskopisch kontrolliert zu operieren.

Methoden

Als Vorteil der minimal-invasiven Vorgehensweise gelten die Reduktion der Zugangsmorbidität, das Erkennen/Mitbehandeln von Begleitpathologien und die direkte visuelle Kontrolle der Frakturreposition.

Limitationen

Limitierend ist ein frakturbegleitender schwerer Weichteilschaden, der den chirurgischen Handlungsspielraum einschränkt.

Schlussfolgerung

Komplexe Frakturen mit Gelenkflächenimpression sowie mehrfragmentäre Brüche werden auch zukünftig weiter konventionell offen reponiert werden. In solchen Situationen bietet der ergänzende Einsatz der (offenen) Arthroskopie die Möglichkeit der intraoperativen direkten Stellungskontrolle der Frakturfragmente.

Abstract

Introduction

Fracture management of the ankle and calcaneus is a domain of open joint surgery; however, in certain cases there are strong arguments for a differentiated approach with arthroscopic control of surgery.

Methoden

The benefits of a minimally invasive procedure are reduced surgical soft tissue damage, detection and treatment of additional joint damage and direct visualization of fracture reduction. Surgical options are limited by severe soft tissue damage accompanying fractures.

Conclusion

Complex fractures with deep impressions of the joint surfaces and multiple fracture lines on the articular side will continue to be treated by conventional open surgery. The additional use of open arthroscopy allows a direct alignment control in such situations.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Schoepp und D. Rixen geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Berufsgenossenschaftliche Unfallklinik Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Deutschland

    C. Schoepp & D. Rixen

  2. Fakultät für Gesundheit, Universität Witten/Herdecke, -, -

    C. Schoepp & D. Rixen

  3. Trauma-Komitee der AGA, -, -

    C. Schoepp

Authors
  1. C. Schoepp
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  2. D. Rixen
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Correspondence to C. Schoepp.

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Schoepp, C., Rixen, D. Arthroskopisch gestütztes Frakturmanagement des oberen und unteren Sprunggelenks. Arthroskopie 27, 299–304 (2014). https://doi.org/10.1007/s00142-013-0802-8

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  • DOI: https://doi.org/10.1007/s00142-013-0802-8

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