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Flexions- und Extensionsosteotomien der proximalen Tibia

Indikationen und Operationstechnik

Flexion and extension osteotomy of the proximal tibia

Indications and surgical technique

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Zusammenfassung

Hintergrund

Isolierte Flexions- oder Extensionsabweichungen der Beinachse sind insgesamt selten. Falls symptomatisch können sie ggf. durch Osteotomien korrigiert und die „range of motion“ (ROM) des Kniegelenks optimiert werden. Neben der Korrektur in der frontalen Ebene lässt sich auch der tibiale Slope (Inklination der tibialen Gelenkfläche) durch Osteotomien beeinflussen und somit eine Osteotomie auch zur Optimierung der biomechanische Kniegelenkstabilität nutzen.

Methode

Eine sorgfältige Planung unter Berücksichtigung aller 3 Raumebenen und der Torsion ist die Grundlage für eine erfolgreiche Operation. Eine darauf aufbauende kontrollierte Operationstechnik unter Berücksichtigung einiger Grundsätze ermöglicht die Veränderung des dreidimensionalen Alignements der Tibia und erlaubt somit neben der Wiederherstellung der anatomischen Achsenverhältnisse das Alignement im Rahmen einer Kompartimententlastung bei fokaler arthrotischer Schädigung und zusätzlich eine Intervention auf die biomechanische Funktion des Kniegelenks.

Abstract

Background

Isolated deviations in flexion and extension of the leg axis are rare. These deviations can be corrected if necessary by osteotomy and the range of motion (ROM) of the knee joint can be optimized. In addition to correction in the frontal plane, the tibial slope (i.e. inclination of the surface of the tibial joint) can also be influenced by osteotomy and therefore osteotomy can also be utilized to optimize the biomechanical stability of the knee joint.

Method

Careful planning taking all three spatial planes and torsion into consideration is the foundation of a successful operation. A controlled surgical technique based on careful planning and some basic principles allows the alteration of the three dimensional alignment of the tibia.

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Einhaltung ethischer Richtlinien

Interessenkonflikt

K. Beitzel, T. Kern und A.B. Imhoff geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, 81675, München, Deutschland

    Knut Beitzel &  Andreas B. Imhoff

  2. BG Unfallklinik Murnau, Murnau, Deutschland

    Thomas Kern

Authors
  1. Knut Beitzel
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  2. Thomas Kern
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  3. Andreas B. Imhoff
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Correspondence to Andreas B. Imhoff.

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Beitzel, K., Kern, T. & Imhoff, A. Flexions- und Extensionsosteotomien der proximalen Tibia. Orthopäde 43, 976–983 (2014). https://doi.org/10.1007/s00132-014-3035-2

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  • DOI: https://doi.org/10.1007/s00132-014-3035-2

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