Zusammenfassung
Berichtet wird über einen Fall mit komplexer posttraumatischer Deformität an beiden Beinen nach Femurschaftfraktur. Dargestellt werden Korrekturmöglichkeiten bei Kombinationsfehlstellung mit Genu valgum und Innentorsionsabweichung sowie mit Verkürzung und Außentorsionsabweichung. Dafür kommen zum einen die Schrägosteotomie und zum anderen ein motorisierter Verlängerungsnagel zur Anwendung.
Abstract
A case of complex posttraumatic deformity after bilateral femoral shaft fractures is reported. Different possibilities for correction in cases of valgus malalignment combined with internal rotation deformity as well as shortening combined with external rotation deformity are presented. Oblique osteotomy and a motorized femoral extension nail were used.
Literatur
Bhave A, Paley D, Herzenberg JE (1999) Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy. J Bone Joint Surg Am 81:529–534
Bretin P, O’loughlin PF, Suero EM et al (2011) Influence of femoral malrotation on knee joint alignment and intra-articular contract pressures. Arch Orthop Trauma Surg 131:1115–1120
Brouwer GM, Van Tol AW, Bergink AP et al (2007) Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 56:1204–1211
Calder P, Mcgrath A, Chasseaud M et al (2013) The precice intramedullary limb lengthening system–early results. Bone Joint J Orthop Proc Suppl 95:11–11
Dincyurek H, Kocaoglu M, Eralp IL et al (2012) Functional results of lower extremity lengthening by motorized intramedullary nails. Acta Orthop Traumatol Turc 46:42–49
Eid AM, Hafez MA (2002) Traumatic injuries of the distal femoral physis. Retrospective study on 151 cases. Injury 33:251–255
Ganger R, Radler C, Speigner B et al (2010) Correction of post-traumatic lower limb deformities using the Taylor spatial frame. Int Ortho 34:723–730
Karaman O, Ayhan E, Kesmezacar H et al (2013) Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life. Eur J Orthop Surg Traum 24:1243–1247
Kettelkamp D, Hillberry B, Murrish D et al (1988) Degenerative arthritis of the knee secondary to fracture malunion. Clin Orthop Relat Res 234:159–169
Kirane YM, Fragomen AT, Rozbruch SR (2014) Precision of the PRECICE internal bone lengthening nail. Clin Orthop Relat Res 472:3869–3878
Krieg AH, Lenze U, Speth BM et al (2011) Intramedullary leg lengthening with a motorized nail. Acta Orthop 82:344–350
Lenze U, Hasler CC, Krieg AH (2011) Intramedullary motorized nail for equalization of posttraumatic leg length discrepancies. Unfallchirurg 114:604–610
Matsubara H, Tsuchiya H, Sakurakichi K et al (2006) Deformity correction and lengthening of lower legs with an external fixator. Int Orthop 30:550–554
Nakase T, Ohzono K, Shimizu N et al (2006) Correction of severe post-traumatic deformities in the distal femur by distraction osteogenesis using Taylor Spatial Frame: a case report. Arch Orthop Trauma Surg 126:66–69
Paley D, Herzenberg J (2005) Principles of Deformity Correction. Springer, Berlin
Rozbruch SR, Kleinman D, Fragomen AT et al (2008) Limb lengthening and then insertion of an intramedullary nail: a case-matched comparison. Clin Orthop Relat Res 466:2923–2932
Schiedel FM, Vogt B, Tretow HL et al (2014) How precise is the PRECICE compared to the ISKD in intramedullary limb lengthening? Reliability and safety in 26 procedures. Acta Orthop 85:293–298
Solomin LN, Paley D, Shchepkina EА et al (2014) A comparative study of the correction of femoral deformity between the Ilizarov apparatus and Ortho-SUV frame. Int Ortho 38:865–872
Streubel PN, Moustoukas MJ, Obremskey WT (2013) Mechanical failure after locking plate fixation of unstable intertrochanteric femur fractures. J Orthop Trauma 27:22–28
Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377
Waidelich HA, Strecker W, Schneider E (1992) Computed tomographic torsion-angle and length measurement of the lower extremity. The methods, normal values and radiation load. Rofo 157:245–251
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M. Ahrend, A. Ateschrang, U. Stöckle und S. Schröter geben an, dass kein Interessenkonflikt besteht.
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W. Mutschler, München
V. Braunstein, München
H. Polzer, München
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Ahrend, M., Ateschrang, A., Stöckle, U. et al. Behandlungsstrategie bei posttraumatischer Komplexdeformität. Unfallchirurg 119, 151–158 (2016). https://doi.org/10.1007/s00113-015-0038-3
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DOI: https://doi.org/10.1007/s00113-015-0038-3