Intramedulläre Stabilisierung und Augmentation mit unter Licht polymerisierendem Methylmethacrylat

Zusammenfassung

Ein neues Verfahren ermöglicht durch das Einspritzen eines Monomers in einen minimalinvasiv intramedullär eingebrachten Ballon mit anschließendem Auspolymerisieren unter Blaulicht die gezielte Stabilisierung und Augmentation insbesondere von osteoporotischen und/oder metastatischen Frakturen. An den oberen Extremitäten kann das ausgehärtete Methylmethacrylat als Stand-alone-Implantat zur Frakturstabilisierung dienen. Es eignet sich auch – vor allem an den unteren Extremitäten – zur intramedullären Augmentation z. B. einer winkelstabilen Plattenosteosynthese im Sinne einer verlängerten Verbundosteosynthese. Bisher gibt es nur wenige klinische Daten bez. dieses Verfahrens, es existieren vor allem Kongressberichte. Das Verfahren muss seinen Wert noch in größeren Fallserien und vergleichenden Studien unter Beweis stellen. Dennoch scheint es eine Option zur Verbesserung der Versorgung von Frakturen bei stark reduzierter Knochensubstanz darzustellen.

Abstract

A new method allows controlled polymerisation of bone cement within the medullary canal. It consists of the minimally invasive injection of a monomer which hardens under blue light. The method seems to be particularly useful in the treatment of osteoporotic and/or metastatic fractures. At the upper extremity it can be used as a stand-alone implant. However, the method is also useful for augmentation of extramedullary implants as angular stable plates. Very few clinical data are currently available, the procedure has to prove its value in larger case series and controlled studies. Nevertheless, this method seems to be an option for improving the treatment of fractures under strongly reduced bony purchase.

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