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Bandverletzungen der unteren Extremität beim älteren Menschen

Ligament ruptures of the lower extremity in the elderly

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Zusammenfassung

Bandverletzungen der unteren Extremität sind auch beim älteren Menschen mit zunehmender Inzidenz festzustellen. Grund für diese Entwicklung ist einerseits die demographische Bevölkerungsentwicklung, andererseits das deutlich erhöhte Aktivitätsniveau und der sportliche Anspruch der älteren Bevölkerung. Im Rahmen dieser Übersichtsarbeit widmen wir uns den wichtigsten Bandverletzungen der unteren Extremität beim älteren Menschen. Während die Quadrizepssehnen- und Achillessehnenruptur eher den degenerativ vorgeschädigten und verschleißbedingten Verletzungen zugerechnet werden können, zählen die vorderen Kreuzbandrupturen der älteren Patienten vermehrt zu den „Spontanrupturen“, welche weniger durch degenerative Vorschäden, als durch adäquate Traumen bei erhöhter Aktivität des älteren Menschen bedingt sind.

Bei der Behandlung derartiger Verletzungen beim älteren Patienten sind v. a. die häufig bestehenden Nebenerkrankungen, das deutlich erhöhte Risiko- und Komplikationsprofil und die potenziell eingeschränkte Compliance in der Nachbehandlung zu beachten und in die Therapieentscheidungen zu integrieren.

Für die operative Behandlung von Bandverletzungen des älteren Patienten sollte es keine festen Altersgrenzen geben, hingegen sollte eine differenzierte Therapieentscheidung erfolgen.

Abstract

There is an increasing incidence of ligament ruptures of the lower extremities in older patients. This higher incidence is caused by the typical current demographic changes in the population and the higher level of activity and athletic motivation of the older people in our society. In this review we address the most important ligament ruptures of the lower extremity in the old patient. Quadriceps tendon and Achilles tendon ruptures are mostly the result of degenerative and abrasion changes. The ACL rupture on the other hand occurs spontaneously after adequate trauma and without former degenerative changes especially in highly active patients.

For a differentiated treatment of the older patient with tendon ruptures, secondary diseases, an increased risk and complication profile and a potentially decreased compliance during rehabilitation must be taken into consideration before indicating operative or conservative therapy.

There are no strict age-related limitations for indication of an operative treatment of tendon ruptures in the older patient. In this patient group a differentiated treatment decision is recommended.

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  1. Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149, Münster, Deutschland

    M. Herbort & M.J. Raschke

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  1. M. Herbort
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  2. M.J. Raschke
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Correspondence to M. Herbort.

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Herbort, M., Raschke, M. Bandverletzungen der unteren Extremität beim älteren Menschen. Unfallchirurg 114, 671–680 (2011). https://doi.org/10.1007/s00113-011-2022-x

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  • DOI: https://doi.org/10.1007/s00113-011-2022-x

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