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Knöchelosteotomie – Die Osteotomie als Zugang

Malleolar osteotomy – Osteotomy as approach

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Zusammenfassung

Bei der Behandlung osteochondraler Läsionen am oberen Sprunggelenk stehen sowohl arthroskopische als auch offene Therapieverfahren zur Verfügung. Die Osteotomien rund um das obere Sprunggelenk haben sich als Zugangserweiterung bei der Behandlung weiter posterior gelegener osteochondraler Läsionen fest etabliert. Bei den relativ häufig anzutreffenden osteochondralen Läsionen im Bereich der medialen Talusschulter wird die mediale, schräge, monoplanare Knöchelosteotomie durchgeführt. Bei den weniger häufigen posterolateralen osteochondralen Läsionen kann die distale Fibulaosteotomie erfolgen. In der vorliegenden Arbeit werden die Indikationen für einzelne Osteotomieverfahren diskutiert und deren chirurgische Techniken beschrieben.

Abstract

Both arthroscopic and open surgical techniques may be used for treatment of osteochondral lesions of the ankle joint. Osteotomy around the ankle joint is a well established technique to extend the approach in cases where the osteochondral lesions are located more posteriorly. Medial, oblique, monoplanar malleolar osteotomy should be used in patients with lesions of the medial talus shoulder. The posterolateral ostechondral lesions are less frequent and in such cases distal fibular osteotomy is recommended. In this study the indications for different forms of osteotomy are discussed and the surgical techniques are described.

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  1. Orthopädische Universitätsklinik Basel, Universitätsspital Basel, Spitalstr. 21, CH-4031, Basel, Schweiz

    A. Barg, G. Pagenstert, A. Leumann &  V. Valderrabano

  2. Harold K. Dunn Forschungslabor, Orthopädische Universitätsklinik, Universität von Utah, Salt Lake City, USA

    A. Barg

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  1. A. Barg
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  2. G. Pagenstert
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Barg, A., Pagenstert, G., Leumann, A. et al. Knöchelosteotomie – Die Osteotomie als Zugang. Orthopäde 42, 309–321 (2013). https://doi.org/10.1007/s00132-012-2007-7

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