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Anwendung der Klingen- und der dynamischen Schraubplattenosteosynthese

The use of blade plate and dynamic screw plate osteosynthesis

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Zusammenfassung

Die Osteosynthese mit Klingenplatten oder dynamischen Schraubensystemen galt lange als Standardverfahren für verschiedene Frakturstabilisierungen bzw. für bestimmte rekonstruktive Eingriffe. In dieser Übersicht werden die heutigen Versorgungsmöglichkeiten mit Klingenplattenosteosynthesen und am Femur mit dynamischen Kondylenschrauben sowie mit der dynamischen Hüftschraube beschrieben. Im Rahmen einer Literaturübersicht werden die aktuellen Indikationen, Ergebnisse und lokalisationsspezifischen Probleme der jeweiligen Osteosyntheseverfahren diskutiert.

Klingenplatten kommen insbesondere im Rahmen von rekonstruktiven Eingriffen sowie bei der Pseudarthrosenversorgung zur Anwendung. Wesentliche Indikation ist die Osteosynthese der Schenkelhalspseudarthrose im Rahmen der Pauwels-Umlagerungsosteotomie. Demgegenüber muss die dynamische Hüftschraube (DHS) als Goldstandardimplantat in der Rekonstruktion von Schenkelhalsfrakturen sowie pertrochantären Frakturen angesehen werden. Die dynamische Kondylenschraube (DCS) hat als Alternative zu anderen winkelstabilen Implantaten unverändert ihre Berechtigung in der Stabilisierung von proximalen und distalen Femurfrakturen.

Abstract

Osteosynthesis in fracture treatment and in some reconstructive procedures with blade plates or dynamic screw systems was the standard procedure for several decades. In this review, the current options and concepts using blade plate osteosynthesis, stabilization of proximal and distal femur fractures and reconstructive procedures with the dynamic hip screw or the dynamic condylar blade are discussed. On the basis of a literature review, the present indications, results and region-specific complications are reported and discussed.

Blade plates are used mainly in the context of reconstructive procedures, as well as in the treatment of pseudoarthroses. The Pauwel procedure in femoral neck non-unions is one of the best known indications. In contrast, the dynamic hip screw is the gold standard for stabilization of femoral neck and most pertrochanteric fractures, whereas the dynamic condylar screw is still an alternative to internal fixators for proximal and distal femoral fracture fixations.

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Correspondence to Prof. Dr. H.J. Oestern.

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Oestern, H., Gänsslen, A. Anwendung der Klingen- und der dynamischen Schraubplattenosteosynthese. Orthopäde 39, 160–170 (2010). https://doi.org/10.1007/s00132-009-1521-8

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Schlüsselwörter

  • Klingenplatte
  • Dynamische Schraubenosteosynthese
  • Indikationen
  • Ergebnisse
  • Komplikationen

Keywords

  • Blade plate
  • Dynamic screw osteosynthesis
  • Indications
  • Results
  • Complications