Augat P, Bühren V
Institut für Biomechanik, Paracelsus Medizinische Privatuniversität Salzburg und Institut für Biomechanik, Murnau, Professor-Küntscher-Str. 8, 82418, Murnau, Deutschland.
Orthopade. 2010 Apr;39(4):397-406. doi: 10.1007/s00132-009-1572-x.
Osteoporosis is characterized by a reduction of bone mass and changes in bone micro-architecture. The resulting reduction in bone strength leads to the well recognized increase in the risk of fracture, particularly at the radius, hip, and spine. The treatment of osteoporotic fractures is challenged by the reduced mechanical capacity of osteoporotic bone, reflected in reduced holding power and increased fragility. The aim of successful fracture treatment in individuals with osteoporosis is early fixation of the fracture with immediate and almost unrestricted weight-bearing capacity. The key factor for effective fracture treatment is strict adherence to the basic principles of stable fracture fixation: reposition, compression, long, wide supports, as well as additive techniques such as angular stability and bone augmentation. Modern osteosynthesis implants effectively support the application of these principles. Modifications in implant design and techniques enable the surgeon to apply and combine the essential components of the basic principles for the treatment of mechanically impaired bone. The key components employed in modern implants include integrated compression techniques, multidirectional angular stability, expandable support surfaces, as well as multiple augmentation options. However, despite modern implant technology, osteoporotic bone fractures remain a significant challenge for the orthopaedic surgeon and require meticulous planning and implementation of the basic principles.
骨质疏松症的特征是骨量减少和骨微结构改变。由此导致的骨强度降低会使骨折风险显著增加，尤其是在桡骨、髋部和脊柱部位。骨质疏松性骨折的治疗面临着骨质疏松骨机械性能下降的挑战，这表现为固定力降低和脆性增加。对骨质疏松症患者进行成功骨折治疗的目标是早期固定骨折，使其具有即刻且几乎不受限制的负重能力。有效治疗骨折的关键因素是严格遵循稳定骨折固定的基本原则：复位、加压、长而宽的支撑，以及诸如角稳定性和骨增强等附加技术。现代骨合成植入物有效地支持了这些原则的应用。植入物设计和技术的改进使外科医生能够应用和组合治疗机械性能受损骨骼的基本原则的基本要素。现代植入物中采用的关键要素包括集成加压技术、多向角稳定性、可扩展支撑表面以及多种增强选项。然而，尽管有现代植入技术，骨质疏松性骨折对骨科医生来说仍然是一项重大挑战，需要精心规划并实施基本原则。
