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Ist eine routinemäßige Implantatentfernung nach unfallchirurgischen Eingriffen sinnvoll?

Is routine implant removal after trauma surgery sensible?

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Zusammenfassung

Wir präsentieren eine Übersicht zu Indikation, Risiken, Komplikationen und klinischen Ergebnissen nach Osteosynthesen an verschiedenen Regionen der Extremitäten und des Körperstamms. Die Indikation zur Implantatentfernung wird heute zurückhaltender gestellt als früher, in Europa aber immer noch häufiger als z. B. in Nordamerika. Der Zeitbedarf für eine Implantatentfernung kann u. U. das geplante Ausmaß erheblich übersteigen und nachhaltige Folgen wie Zerstörung der knöchernen Integrität, Infektionen und andere Probleme nach sich ziehen. Nicht zuletzt aus diesem Grunde muss die Indikation zurückhaltend und kritisch gestellt werden. Die umfassende Aufklärung des Patienten über Probleme aber auch die Alternativen, den Eingriff zu reduzieren oder ganz zu unterlassen, haben vor diesem Hintergrund einen ganz besonderen Stellenwert.

Abstract

We present a literature review about implant removal after operative extremity and spine fracture treatment. The indication for implant removal procedures has become less frequent in recent years, but is still more common in Europe than for example in North America. The time required to perform a implant removal can easily exceed the planned amount. Implant removal can result in significant complications like soft tissue damage, fractures, infections, and other problems. Not only because of these problems, the decision on whether or not to remove the implant should be made with great care. Therefore good communication with the patient and thorough information about risks and benefits are essential.

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  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30173, Hannover, Deutschland

    C. Krettek FRACS, FRCSEd, C. Müller, R. Meller, M. Jagodzinski, F. Hildebrand & R. Gaulke

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  1. C. Krettek FRACS, FRCSEd
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  2. C. Müller
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  3. R. Meller
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  4. M. Jagodzinski
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Correspondence to C. Krettek FRACS, FRCSEd.

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Krettek, C., Müller, C., Meller, R. et al. Ist eine routinemäßige Implantatentfernung nach unfallchirurgischen Eingriffen sinnvoll?. Unfallchirurg 115, 315–322 (2012). https://doi.org/10.1007/s00113-012-2159-2

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