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Erschienen in: Die Unfallchirurgie 4/2021

05.03.2021 | Konservative Therapie | CME

Osteochondrale Läsionen des Talus

Individualisiertes Vorgehen mithilfe etablierter und innovativer Rekonstruktionsverfahren

verfasst von: PD Dr. Christian David Weber, Prof. Dr. Gino Kerkhoffs, Dr. Jari Dahmen, PD Dr. Dariush Arbab, Prof. Dr. Philipp Kobbe, Frank Hildebrand, PD Dr. Philipp Lichte

Erschienen in: Die Unfallchirurgie | Ausgabe 4/2021

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Zusammenfassung

Osteochondrale Läsionen (OCL) des Talus sind definiert als Knorpelschäden mit subchondraler Beteiligung. Die traumatische Genese ist bedeutsam; insbesondere Distorsionen und Frakturen am Sprunggelenk können zu Läsionen der Knorpeloberfläche und der subchondralen Lamelle führen. In der Folge können instabile Läsionen und subchondrale Zysten erhebliche andauernde Schmerzen und funktionelle Einschränkungen auslösen. Eine primäre konservative Therapie ist v. a. bei Kindern und Jugendlichen zu erwägen; die Rückkehr zu sportlicher Aktivität ist aber oft nur eingeschränkt realisierbar. Rekonstruktive operative Therapieprinzipien umfassen interne Fixation des osteochondralen Fragments, Knochenmarkstimulation, membranaugmentierte Chondrogenese ± Spongiosaplastik, osteochondralen Transfer, retrograde Techniken ± Spongiosaplastik, (matrixassoziierte) autologe Chondrozytenimplantation und autologe Transplantation von osteoperiostalem Beckenkamm. Ergänzende operative Verfahren zur Stabilisierung bzw. Achskorrektur sind ggf. zu erwägen.
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Metadaten
Titel
Osteochondrale Läsionen des Talus
Individualisiertes Vorgehen mithilfe etablierter und innovativer Rekonstruktionsverfahren
verfasst von
PD Dr. Christian David Weber
Prof. Dr. Gino Kerkhoffs
Dr. Jari Dahmen
PD Dr. Dariush Arbab
Prof. Dr. Philipp Kobbe
Frank Hildebrand
PD Dr. Philipp Lichte
Publikationsdatum
05.03.2021
Verlag
Springer Medizin
Erschienen in
Die Unfallchirurgie / Ausgabe 4/2021
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI
https://doi.org/10.1007/s00113-021-00964-1

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