ISSN:
1434-3916
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Zusammenfassung Es wird über das Ausheilungsergebnis von 193 konservativ behandelten frischen Kahnbeinfrakturen der Hand berichtet. Zum Kontrollzeitpunkt — durchschnittlich 4,5 Jahre nach Fraktur —waren 190 (98,4%) knöchern geheilt und 3 (1,6%) wiesen eine Pseudarthrose auf. Als Ursachen der Pseudarthrosenentstehung, konnte eine zu kurze Fixationszeit und die Fragtperltdiastase objektiviert werden. Die Arthroserate im nachuntersuchten Patientengut lag unter 1%. Ein operativer Eingriff (offene Reposition und Verschraubung) ist primär zu erwägen, wenn ein vertikaler Schrägbruch oder eine Fraktur mit breiter Diastase vorliegt. Eine sekundäre Kahnbeinverschraubung wird für die verzögerte Knochenbruchheilung empfohlen.
Notes:
Summary The results of 193 conservatively treated acute fractures of the carpal navicular are presented. Ninety-eight (50.7%) had horizontal oblique fractures, 82 (42.5%) transverse, and 13 (6.8%) vertical oblique fractures. In 23 (11.9%) cases the fracture was located in the proximal third, in 125 (64.7%) in the middle third, and in 45 (23.4%) in the distal third. An unpadded cast extending from the elbow to the metacarpophalangeal joints including the thumb was used generally. On the following day the cast was always completed by addition of a volar plaster splint and a circular plaster bandage. Duration of immobilization lasted from 6 to 16 weeks (mean: 10 weeks). On average, 4.5 years after injury 190 (98.4%) fractures had healed by osseous union and 3 (1.6%) had a pseudarthrosis. The reasons for non-union were too short time of immobilization, and former diastasis between the fragments. The number of arthrosis in the radiocarpal joint in our patients amounted to less than 1%. Primary operative treatment (open reduction and screwing) is preferred for vertical oblique fractures and for fractures with a large diastasis between the fragments. Secondary operative treatment is performed if there are no signs of osseous consolidation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00450938
