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Der posteriore Malleolus bzw. das Volkmann-Dreieck

Eine Vergangenheitsbewältigung

The posterior malleolus or Volkmann’s triangle

Coming to terms with the past

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Zusammenfassung

Die Therapie des Volkmann-Dreiecks ist in den letzten Jahren ein sehr kontroverses Thema in der Behandlung von Malleolarfrakturen geworden. Neuere Arbeiten stellen die jahrzehntelange „Drittelregel“ von Nelson und Jensen in Frage. Unbestritten ist aber auch heute, dass eine Instabilität im oberen Sprunggelenk eine Prädisposition zu einer posttraumatischen Arthrose darstellt und verhindert werden muss. Die operative Fixation ist aus anatomischen Gründen nicht ganz einfach und verlangt ein ganz klares, technisch präzises Vorgehen. Tipps und Tricks helfen dabei. Aktuelle Indikation und therapeutisches Vorgehen werden dargestellt.

Abstract

Having observed Nelsons and Jensen’s rule for the fixation of the posterior malleolus in ankle fractures for over 70 years recent studies have shown that this dogma might have its limitations. Today no one can determine with absolute conviction what to do with this controversial fragment. To fix it operatively means to follow some strict surgical procedures (e.g. anatomy, approach and placement of implants). These guidelines are presented, the indications for fixation are discussed and the prognosis for these difficult fractures is outlined.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. D. Heim gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Chir-Orthop Abteilung, Spital Frutigen, Adelbodenstraße 27 , CH-3714, Frutigen, Schweiz

    D. Heim

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Heim, D. Der posteriore Malleolus bzw. das Volkmann-Dreieck. Unfallchirurg 116, 781–788 (2013). https://doi.org/10.1007/s00113-013-2384-3

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