Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen am Becken

Zusammenfassung

Korrekturbedürftige Fehlheilungen und Pseudarthrosen sind nach aktuellen Prinzipien folgendener Primärbehandlung der Verletzung in Deutschland selten. Korrektureingriffe sind indiziert, wenn erheblicher, sicher beckenbedingter, Leidensdruck besteht und Fehlstellungen mit und ohne knöcherner Heilung vorliegen. Eine umfassende präoperative Diagnostik, Analyse und Planung ist die Grundlage von korrigierenden Eingriffen. Diese risikobeladenen, aufwendigen Operationen sollten daher nur spezialisierten Zentren vorbehalten werden. Bei strenger Indikationsstellung und konsequenter Operationsdurchführung ist in vielen Fällen allerdings eine deutliche Steigerung der Lebensqualität erreichbar.

Abstract

In the German setting late pelvic corrections are rarely neccessary, as Trauma Networks and a very structured organization of injury care ensures good patient selection and distribution into specialized trauma and pelvic centers. However nonunions and malunions occur and diagnostics, indications and decision making for late correction osteotomies are discussed. The surgical pelvic correction is to be considered an ambitious surgery with many risks for general and specific complications. Therefore care has to be taken, surgery and especially the sequence of neccessary procedures are based on thorough analyses and planning. The accumulation of these interventopns in highly specialized “Pelvic Centres” is recommended.

Schlüsselwörter

Beckenpseudarthrose - Beckenfehlheilung - Beckenkorrekturoperationen - Planung - Operationssequenz

Key words

pelvic nonunions - pelvic malhealing - pelvic correction osteotomies - planning - surgical strategies

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