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Untere Extremität

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Facharztwissen Orthopädie Unfallchirurgie

Zusammenfassung

  • Entwicklung

    • Becken/Acetabulum: siehe Becken

    • Femur: Diaphysäre Knochenbildung ab der 7. Embryonalwoche. Der epiphysäre Knochenkern distal ist bei Geburt vorhanden (Reifezeichen), proximal zeigt er sich epiphysär im Kopfbereich ab dem 6. Lebensmonat, im Trochanter major ab dem 3. Lebensjahr und im Trochanter minor ab dem 12. Lebensjahr

      • Proximal schließt sich die Wachstumsfuge ab dem 16. Lebensjahr, distal erst um das 20. Lebensjahr

      • Das Auftreten eines Ossifikationszentrums im Trochanter major (3. Lebensjahr) wandelt ihn auch zur Apophyse um. Verletzungen der Wachstumsfuge in diesem Bereich führen somit zur Coxa valga, da das Schenkelhalswachstum unverändert fortschreitet, das Wachstum des Trochanter majors jedoch zurückbleiben kann

    • Beitrag zum Längenwachstum: Proximale Epiphysenfuge

      • 30 % des Längenwachstums des Femurs

      • 10 % des Längenwachstums des gesamten Beins

  • Gefäßversorgung

    • Acetabulum

      • Anteriorer Teil und größter Teil der Fossa acetabuli: A. obturatoria

      • Pfannendach: A. glutea superior

      • Posteriorer Teil: A. glutea inferior, A. pudenda interna

  • Femurkopf und -hals: A. profunda femoris (A. circumflexa femoris medialis und lateralis). Die arterielle Versorgung über das Lig. capitis femoris sistiert meist im frühen Kindesalter

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  1. Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München, München, Deutschland

    Dr. med. Norbert Harrasser, Prof. Dr. med. Stefan Huber-Wagner, Univ.-Prof. Dr. med. Rüdiger von Eisenhart-Rothe & Univ.-Prof. Dr. med. Peter Biberthaler

  2. Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland

    Prof. Dr. med. Hans Gollwitzer, Dr. med. Andreas Toepfer, Dr. med. Carolin Knebel, Dr. med. Johannes Margraf, Dr. med. Ingo Banke, Dr. med. Johannes Schauwecker, Prof. Dr. med. Andreas B. Imhoff & Bastian Grüttner

  3. Klinik für Kinderorthopädie, Klinikum Schwabing, Kölner Platz 1, München, Deutschland

    Dr. med. Maya Salzmann & Dr. med. Nina Berger

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  1. Klinik und Poliklinik für Orthopädie, Klinikum rechts der Isar der TU München, München, Germany

    Norbert Harrasser

  2. Klinik und Poliklinik für Orthopädie, Klinikum rechts der Isar der TU München, München, Bayern, Germany

    Rüdiger Eisenhart-Rothe

  3. Klinik & Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München, München, Germany

    Peter Biberthaler

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Harrasser, N. et al. (2016). Untere Extremität. In: Harrasser, N., Eisenhart-Rothe, R., Biberthaler, P. (eds) Facharztwissen Orthopädie Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44463-4_8

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