Komplikationsmanagement in der operativen Versorgung der Humeruskopffraktur

Arthroskopie - Tập 33 - Trang 120-126 - 2020
M. Galler1, J. Zellner1
1Klinik für Unfallchirurgie, Caritas-Krankenhaus St. Josef Regensburg, Regensburg, Deutschland

Tóm tắt

Die operative Versorgung von proximalen Humeruskopffrakturen gewinnt immer mehr an Bedeutung und stellt zunehmend eine Herausforderung in der Unfallchirurgie dar. Hierdurch muss auch ein entsprechendes Wissen um die möglichen Komplikationen und deren Management mitsamt den Implantaten vorhanden sein. Hierbei können intra- von postoperativen Komplikationen unterschieden werden. Zu den intraoperativen Komplikationen zählen schwierige und unzureichende Reposition bei Varus- oder Valgus-dislozierten Frakturen, v. a. bei osteoporotischem Knochen und inadäquater Implantatpositionierung mit intraartikulärer Schrauben- oder Knochenzementlage. Ein weiterer wichtiger Punkt sind die postoperativen Komplikationen mit Infektion, Humeruskopfnekrose, Tuberkularesorption, Notching und Luxation bei Schulterprothesen und abschließend periprothetische Humerusschaftfrakturen. Es sollen Pitfalls, Strategien zur Vermeidung sowie Korrekturmöglichkeiten erörtert werden, um eine bestmögliche Versorgung dieser Frakturen zu ermöglichen.

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