Skip to main content
Erschienen in: Oral and Maxillofacial Surgery 4/2009

01.12.2009 | Case Report

Mandibular fractures associated with endosteal implants

verfasst von: Bruno Ramos Chrcanovic, Antônio Luís Neto Custódio

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 4/2009

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study is to report four cases of mandibular fractures associated with endosteal implants and to discuss prevention and treatment of these types of fractures.

Discussion

To evaluate whether the patient's anatomy allows insertion of implants, radiological exams that demonstrate the height and the labial–lingual width are needed. To reduce the potential fracture problem, the mandible can be restrengthened with bone grafting techniques. The treatment of a fracture in an atrophic mandible is always a challenge because of the diminished central blood supply, the depressed vitality of the bone, and the dependence on the periosteal blood supply. The basic principles in fracture treatment are reduction and immobilization of the fractured site for restoration of form and function.

Conclusions

If implants are placed in severe atrophic mandible, iatrogenic fracture of the mandible may occur during or after implant surgery because implant placement weakens the already-compromised mandible. A few millimeters of cortical bone should remain on both the labial and the lingual sites after the hole for insertion of an implant has been drilled. A 3-D surgical planning should be recommended at least in severe atrophic mandibles in order to prevent a severe reduction of bone tissue.
Literatur
1.
Zurück zum Zitat Brånemark P-I, Hansson BO, Adell R, Breine U, Lindström J, Hallen O, Ohman A (1977) Osseointegrated implants in the treatment of the edentulous jaw: experience from a ten-year period. Scand J Plast Reconstr Surg 11(Suppl 16):1–132 Brånemark P-I, Hansson BO, Adell R, Breine U, Lindström J, Hallen O, Ohman A (1977) Osseointegrated implants in the treatment of the edentulous jaw: experience from a ten-year period. Scand J Plast Reconstr Surg 11(Suppl 16):1–132
2.
Zurück zum Zitat Albrektsson T (1988) A multicenter report on osseointegrated oral implants. J Prosthet Dent 60:75–84CrossRefPubMed Albrektsson T (1988) A multicenter report on osseointegrated oral implants. J Prosthet Dent 60:75–84CrossRefPubMed
3.
Zurück zum Zitat Binder T (1989) Osteomyelitis and pathological fracture after implant placement in the edentulous mandible. Z Zahnärztl Implantol 5:12–24 Binder T (1989) Osteomyelitis and pathological fracture after implant placement in the edentulous mandible. Z Zahnärztl Implantol 5:12–24
4.
Zurück zum Zitat Goodarce CJ, Kan JYK, Rungcharassaeng K (1999) Clinical complications of osseointegrated implants. J Prosthet Dent 81:537–552CrossRef Goodarce CJ, Kan JYK, Rungcharassaeng K (1999) Clinical complications of osseointegrated implants. J Prosthet Dent 81:537–552CrossRef
5.
Zurück zum Zitat Kan JYK, Lozada JL, Boyne PJ, Goodacre CJ, Rungcharassaeng K (1997) Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report. Int J Oral Maxillofac Implants 12:655–659PubMed Kan JYK, Lozada JL, Boyne PJ, Goodacre CJ, Rungcharassaeng K (1997) Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report. Int J Oral Maxillofac Implants 12:655–659PubMed
6.
Zurück zum Zitat Keller EE (1995) Reconstruction of the severely atrophic edentulous mandible with endosseous implants: a 10-year longitudinal study. J Oral Maxillofac Surg 53:305–320CrossRefPubMed Keller EE (1995) Reconstruction of the severely atrophic edentulous mandible with endosseous implants: a 10-year longitudinal study. J Oral Maxillofac Surg 53:305–320CrossRefPubMed
7.
Zurück zum Zitat Mason ME, Triplett RG, Van Sickels JE, Parel SM (1990) Mandibular fractures through endosseous cylinder implants: report of four cases and review. J Oral Maxillofac Surg 8:311–317CrossRef Mason ME, Triplett RG, Van Sickels JE, Parel SM (1990) Mandibular fractures through endosseous cylinder implants: report of four cases and review. J Oral Maxillofac Surg 8:311–317CrossRef
8.
Zurück zum Zitat Neyt L, De Clercq C, Abeloos J, Mommaerts M (1993) Onderkakkfracturen na het plaatsen van tandimplantaten (Mandibular fractures following inserting of dental implants). Acta Stomatol Belg 90:251–258PubMed Neyt L, De Clercq C, Abeloos J, Mommaerts M (1993) Onderkakkfracturen na het plaatsen van tandimplantaten (Mandibular fractures following inserting of dental implants). Acta Stomatol Belg 90:251–258PubMed
9.
Zurück zum Zitat Rothman SLG, Schwarz MS, Chafetz NI (1995) High-resolution compurtized tomography and nuclear bone scanning in the diagnosis of postoperative stress fractures of the mandible: a clinical report. Int J Oral Maxillofac Implants 10:765–768PubMed Rothman SLG, Schwarz MS, Chafetz NI (1995) High-resolution compurtized tomography and nuclear bone scanning in the diagnosis of postoperative stress fractures of the mandible: a clinical report. Int J Oral Maxillofac Implants 10:765–768PubMed
10.
Zurück zum Zitat Schug T, Dumbach J, Rodemer H (1999) Unterkieferfraktur. Eine seltene implantologische Komplikation. Mund Kiefer GesichtsChir 3:335–337CrossRefPubMed Schug T, Dumbach J, Rodemer H (1999) Unterkieferfraktur. Eine seltene implantologische Komplikation. Mund Kiefer GesichtsChir 3:335–337CrossRefPubMed
11.
Zurück zum Zitat Shonberg DC, Stith HD, Jameson AM, Chai JY (1992) Mandibular fracture through an endosseous implant. Int J Oral Maxillofac Implants 7:401–404 Shonberg DC, Stith HD, Jameson AM, Chai JY (1992) Mandibular fracture through an endosseous implant. Int J Oral Maxillofac Implants 7:401–404
12.
Zurück zum Zitat Tolman DE, Keller EE (1991) Management of mandibular fractures in patients with endosseous implants. Int J Oral Maxillofac Implants 6:427–436PubMed Tolman DE, Keller EE (1991) Management of mandibular fractures in patients with endosseous implants. Int J Oral Maxillofac Implants 6:427–436PubMed
13.
Zurück zum Zitat Raghoebar GM, Stellingsma K, Batenburg RH, Vissink A (2000) Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:553–559CrossRefPubMed Raghoebar GM, Stellingsma K, Batenburg RH, Vissink A (2000) Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:553–559CrossRefPubMed
14.
Zurück zum Zitat Stellingsma C, Vissink A, Meijer HJ, Kuiper C, Raghoebar GM (2004) Implantology and the severely resorbed edentulous mandible. Crit Rev Oral Biol Med 15:240–248CrossRefPubMed Stellingsma C, Vissink A, Meijer HJ, Kuiper C, Raghoebar GM (2004) Implantology and the severely resorbed edentulous mandible. Crit Rev Oral Biol Med 15:240–248CrossRefPubMed
15.
Zurück zum Zitat Bosker H, Jordan RD, Sindet-Petersen S, Koole R (1991) The transmandibular implant: a 13-year survey of its use. J Oral Maxillofac Surg 49:482–492CrossRefPubMed Bosker H, Jordan RD, Sindet-Petersen S, Koole R (1991) The transmandibular implant: a 13-year survey of its use. J Oral Maxillofac Surg 49:482–492CrossRefPubMed
16.
Zurück zum Zitat Bosker H, Van Dijk L (1989) The transmandibular implant: a 12-year follow-up study. J Oral Maxillofac Surg 47:442–450CrossRefPubMed Bosker H, Van Dijk L (1989) The transmandibular implant: a 12-year follow-up study. J Oral Maxillofac Surg 47:442–450CrossRefPubMed
17.
Zurück zum Zitat Maxson BB, Sindet-Petersen S, Tideman H, Fonseca R, Zijlstra G (1989) Multicenter follow-up study of the transmandibular implant. J Oral Maxillofac Surg 47:785–789PubMedCrossRef Maxson BB, Sindet-Petersen S, Tideman H, Fonseca R, Zijlstra G (1989) Multicenter follow-up study of the transmandibular implant. J Oral Maxillofac Surg 47:785–789PubMedCrossRef
18.
Zurück zum Zitat Brånemark P-I, Zarb G, Albrektsson T (1985) Tissue-integrated prostheses. Osseointegration in clinical dentistry. Quintessence Publishing, Chicago Brånemark P-I, Zarb G, Albrektsson T (1985) Tissue-integrated prostheses. Osseointegration in clinical dentistry. Quintessence Publishing, Chicago
19.
Zurück zum Zitat Worthington P (1992) Clinical aspects of severe mandibular atrophy. In: Worthington P, Brånemark PI (eds) Advanced osseointegration surgery. Quintessence Books, Chicago, pp 119–122 Worthington P (1992) Clinical aspects of severe mandibular atrophy. In: Worthington P, Brånemark PI (eds) Advanced osseointegration surgery. Quintessence Books, Chicago, pp 119–122
20.
Zurück zum Zitat ten Bruggenkate CM, Asikainen P, Foitzik C, Krekeler G, Sutter F (1998) Short (6-mm) non-submerged dental implants: results of a multicenter clinical trial of 1 to 7 years. Int J Oral Maxillofac Implants 13:791–798PubMed ten Bruggenkate CM, Asikainen P, Foitzik C, Krekeler G, Sutter F (1998) Short (6-mm) non-submerged dental implants: results of a multicenter clinical trial of 1 to 7 years. Int J Oral Maxillofac Implants 13:791–798PubMed
21.
Zurück zum Zitat Deporter D, Watson P, Pharoah M, Todescan R, Tomlinson G (2002) Ten-year results of a prospective study using porous-surfaced dental implants and a mandibular overdenture. Clin Implant Dent Relat Res 4:183–189CrossRefPubMed Deporter D, Watson P, Pharoah M, Todescan R, Tomlinson G (2002) Ten-year results of a prospective study using porous-surfaced dental implants and a mandibular overdenture. Clin Implant Dent Relat Res 4:183–189CrossRefPubMed
22.
Zurück zum Zitat Friberg B, Grondahl K, Lekholm U, Brånemark PI (2000) Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. Clin Implant Dent Relat Res 2:184–189CrossRefPubMed Friberg B, Grondahl K, Lekholm U, Brånemark PI (2000) Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. Clin Implant Dent Relat Res 2:184–189CrossRefPubMed
23.
Zurück zum Zitat Geertman ME, Boerrigter EM, Van Waas MAJ, van Oort RP (1996) Clinical aspects of a multicenter clinical trial of implantretained mandibular overdentures in patients with severely resorbed mandibles. J Prosthet Dent 75:194–204CrossRefPubMed Geertman ME, Boerrigter EM, Van Waas MAJ, van Oort RP (1996) Clinical aspects of a multicenter clinical trial of implantretained mandibular overdentures in patients with severely resorbed mandibles. J Prosthet Dent 75:194–204CrossRefPubMed
24.
Zurück zum Zitat Stellingsma C, Meijer HJ, Raghoebar GM (2000) Use of short endosseous implants and an overdenture in the extremely resorbed mandible: a five-year retrospective study. J Oral Maxillofac Surg 58:382–387CrossRefPubMed Stellingsma C, Meijer HJ, Raghoebar GM (2000) Use of short endosseous implants and an overdenture in the extremely resorbed mandible: a five-year retrospective study. J Oral Maxillofac Surg 58:382–387CrossRefPubMed
25.
Zurück zum Zitat Stellingsma C, Raghoebar GM, Meijer HJA, Stegenga B, de Bont LGM (2004) The extremely resorbed mandible: two-year results of a comparative, prospective study of three treatment modalities. Part I: clinical results. Int J Oral Maxillofac Implants 19:563–577PubMed Stellingsma C, Raghoebar GM, Meijer HJA, Stegenga B, de Bont LGM (2004) The extremely resorbed mandible: two-year results of a comparative, prospective study of three treatment modalities. Part I: clinical results. Int J Oral Maxillofac Implants 19:563–577PubMed
26.
Zurück zum Zitat Triplett RG, Mason ME, Alfonso WF, McAnear JT (1991) Endosseous cylinder implants in severely atrophic mandibles. Int J Oral Maxillofac Implants 6:264–269PubMed Triplett RG, Mason ME, Alfonso WF, McAnear JT (1991) Endosseous cylinder implants in severely atrophic mandibles. Int J Oral Maxillofac Implants 6:264–269PubMed
27.
Zurück zum Zitat Batenburg RHK, Meijer HJA, Raghoebar GM, Van Oort RP, Boering G (1998) Mandibular overdentures supported by two Brånemark, IMZ or ITI implants. A prospective comparative preliminary study: one-year results. Clin Oral Impl Res 9:374–383CrossRef Batenburg RHK, Meijer HJA, Raghoebar GM, Van Oort RP, Boering G (1998) Mandibular overdentures supported by two Brånemark, IMZ or ITI implants. A prospective comparative preliminary study: one-year results. Clin Oral Impl Res 9:374–383CrossRef
28.
Zurück zum Zitat Batenburg RHK, Meijer HJA, Raghoebar GM, Visink A (1998) Treatment concept for mandibular overdentures supported by endosseous implants: a literature review. Int J Oral Maxillofac Implants 13:539–545PubMed Batenburg RHK, Meijer HJA, Raghoebar GM, Visink A (1998) Treatment concept for mandibular overdentures supported by endosseous implants: a literature review. Int J Oral Maxillofac Implants 13:539–545PubMed
29.
Zurück zum Zitat Adell R, Lekholm U, Rockler B, Brånemark PI (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 10:387–416CrossRefPubMed Adell R, Lekholm U, Rockler B, Brånemark PI (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 10:387–416CrossRefPubMed
30.
Zurück zum Zitat Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986) The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1:11–25PubMed Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986) The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1:11–25PubMed
31.
Zurück zum Zitat Esposito M, Hirsch J, Lekholm U, Thomsen P (1999) Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants 14:473–490PubMed Esposito M, Hirsch J, Lekholm U, Thomsen P (1999) Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants 14:473–490PubMed
32.
Zurück zum Zitat Esposito M, Hirsch JM, Lekholm U, Thomsen P (1998) Biological factors contributing to failures of osseointegrated oral implants (I). Success criteria and epidemiology. Eur J Oral Sci 106:527–551CrossRefPubMed Esposito M, Hirsch JM, Lekholm U, Thomsen P (1998) Biological factors contributing to failures of osseointegrated oral implants (I). Success criteria and epidemiology. Eur J Oral Sci 106:527–551CrossRefPubMed
33.
Zurück zum Zitat Reddy MS, Mayfield-Donahoo T, Vanderven FJ, Jeffcoat MK (1994) A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 5:229–238CrossRefPubMed Reddy MS, Mayfield-Donahoo T, Vanderven FJ, Jeffcoat MK (1994) A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 5:229–238CrossRefPubMed
34.
Zurück zum Zitat Sanna AM, Molly L, van Steenberghe D (2007) Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: a cohort study of consecutive patients. J Prosthet Dent 97:331–339CrossRefPubMed Sanna AM, Molly L, van Steenberghe D (2007) Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: a cohort study of consecutive patients. J Prosthet Dent 97:331–339CrossRefPubMed
35.
Zurück zum Zitat Verstreken K, van Cleynenbreugel J, Marchal G, Naert I, Suetens P, van Steenberghe D (1996) Computer-assisted planning of oral implant surgery: a 3-dimensional approach. Int J Oral Maxillofac Implants 11:806–810PubMed Verstreken K, van Cleynenbreugel J, Marchal G, Naert I, Suetens P, van Steenberghe D (1996) Computer-assisted planning of oral implant surgery: a 3-dimensional approach. Int J Oral Maxillofac Implants 11:806–810PubMed
36.
Zurück zum Zitat Wittwer G, Adeyemo WL, Schicho K, Birkfellner W, Enislidis G (2007) Prospective randomized clinical comparison of 2 dental implant navigation systems. Int J Oral Maxillofac Implants 22:785–790PubMed Wittwer G, Adeyemo WL, Schicho K, Birkfellner W, Enislidis G (2007) Prospective randomized clinical comparison of 2 dental implant navigation systems. Int J Oral Maxillofac Implants 22:785–790PubMed
37.
Zurück zum Zitat Bell RB, Blakey GH, White RP, Hillebrand DG, Molina A (2002) Staged reconstruction of the severely atrophic mandible with autogenous bone graft and endosteal implants. J Oral Maxillofac Surg 60:1135–1141CrossRefPubMed Bell RB, Blakey GH, White RP, Hillebrand DG, Molina A (2002) Staged reconstruction of the severely atrophic mandible with autogenous bone graft and endosteal implants. J Oral Maxillofac Surg 60:1135–1141CrossRefPubMed
38.
Zurück zum Zitat Vermeeren JIJF, Wismeijer D, Van Waas MAJ (1996) One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants. Int J Oral Maxillofac Surg 25:112–115CrossRefPubMed Vermeeren JIJF, Wismeijer D, Van Waas MAJ (1996) One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants. Int J Oral Maxillofac Surg 25:112–115CrossRefPubMed
39.
Zurück zum Zitat Chin M, Toth BA (1996) Distraction osteogenesis in maxillofacial surgery using internal devices: review of five cases. J Oral Maxillofac Surg 54:45–53CrossRefPubMed Chin M, Toth BA (1996) Distraction osteogenesis in maxillofacial surgery using internal devices: review of five cases. J Oral Maxillofac Surg 54:45–53CrossRefPubMed
40.
Zurück zum Zitat Hidding J, Lazar F, Zoller JE (1999) Erste Ergebnisse bei der vertikalen Distraktionsosteogenese des atrophischen Alveolarkamms. Mund Kiefer Gesichtschir 3(Suppl 1):79–83CrossRef Hidding J, Lazar F, Zoller JE (1999) Erste Ergebnisse bei der vertikalen Distraktionsosteogenese des atrophischen Alveolarkamms. Mund Kiefer Gesichtschir 3(Suppl 1):79–83CrossRef
41.
Zurück zum Zitat Prein J (1998) Manual of internal fixation in the cranio-facial skeleton. Springer-Verlag, Berlin, p 57 Prein J (1998) Manual of internal fixation in the cranio-facial skeleton. Springer-Verlag, Berlin, p 57
42.
Zurück zum Zitat Spiessl B (1989) Internal fixation of the mandible. Springer-Verlag, Berlin, p 235 Spiessl B (1989) Internal fixation of the mandible. Springer-Verlag, Berlin, p 235
43.
Zurück zum Zitat Edwards TJ, David DJ, Simpson DA, Abbott AH (1994) The relationship between fracture severity and complication rate in miniplate osteosynthesis of mandibular fractures. Br J Plast Surg 47:310–311CrossRefPubMed Edwards TJ, David DJ, Simpson DA, Abbott AH (1994) The relationship between fracture severity and complication rate in miniplate osteosynthesis of mandibular fractures. Br J Plast Surg 47:310–311CrossRefPubMed
44.
Zurück zum Zitat Kraszewski J, Swider M, Nowicki Z (1978) Bruxism as a complicating factor in mandibular fractures. Czas Stomatol 31:1147–1149PubMed Kraszewski J, Swider M, Nowicki Z (1978) Bruxism as a complicating factor in mandibular fractures. Czas Stomatol 31:1147–1149PubMed
45.
Zurück zum Zitat Scolozzi P, Richter M (2003) Treatment of severe mandibular fractures using AO reconstruction plates. J Oral Maxillofac Surg 61:458–461CrossRefPubMed Scolozzi P, Richter M (2003) Treatment of severe mandibular fractures using AO reconstruction plates. J Oral Maxillofac Surg 61:458–461CrossRefPubMed
46.
Zurück zum Zitat Azumi H, Yoshikawa Y, Nagase M, Nakazima T (1980) Pathological fracture of the mandible resulting from osteomyelitis: report of cases. J Oral Surg 38:525–529PubMed Azumi H, Yoshikawa Y, Nagase M, Nakazima T (1980) Pathological fracture of the mandible resulting from osteomyelitis: report of cases. J Oral Surg 38:525–529PubMed
47.
Zurück zum Zitat Cope MR (1982) Spontaneous fracture of an atrophic edentulous mandible treated without fixation. Br J Oral Surg 20:22–30CrossRefPubMed Cope MR (1982) Spontaneous fracture of an atrophic edentulous mandible treated without fixation. Br J Oral Surg 20:22–30CrossRefPubMed
48.
Zurück zum Zitat Silberman M, Maloney PL, Doku CH (1972) Spontaneous healing of a large osteomyelitic defect in the mandible: report of a case. J Oral Surg 30:821–823 Silberman M, Maloney PL, Doku CH (1972) Spontaneous healing of a large osteomyelitic defect in the mandible: report of a case. J Oral Surg 30:821–823
49.
Zurück zum Zitat Ogasawara T, Sano K, Hatsusegawa C, Miyauchi K, Nakamura M, Matsuura H (2008) Pathological fracture of the mandible resulting from osteomyelitis successfully treated with only intermaxillary elastic guiding. Int J Oral Maxillofac Surg 37:581–583CrossRefPubMed Ogasawara T, Sano K, Hatsusegawa C, Miyauchi K, Nakamura M, Matsuura H (2008) Pathological fracture of the mandible resulting from osteomyelitis successfully treated with only intermaxillary elastic guiding. Int J Oral Maxillofac Surg 37:581–583CrossRefPubMed
50.
Zurück zum Zitat Gerhards F, Kuffner HD, Wagner W (1998) Pathological fractures of the mandible: a review of the etiology and treatment. Int J Oral Maxillofac Surg 27:186–190CrossRefPubMed Gerhards F, Kuffner HD, Wagner W (1998) Pathological fractures of the mandible: a review of the etiology and treatment. Int J Oral Maxillofac Surg 27:186–190CrossRefPubMed
Metadaten
Titel
Mandibular fractures associated with endosteal implants
verfasst von
Bruno Ramos Chrcanovic
Antônio Luís Neto Custódio
Publikationsdatum
01.12.2009
Verlag
Springer-Verlag
Erschienen in
Oral and Maxillofacial Surgery / Ausgabe 4/2009
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-009-0171-7

Weitere Artikel der Ausgabe 4/2009

Oral and Maxillofacial Surgery 4/2009 Zur Ausgabe

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.