Operative Zugangswege zur Hüfte beim älteren Menschen
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- 作者：Univ. Prof. Mag. Dr. M. Nogler MAS ; MSc. ; M. Thaler
- 关键词：SchlüsselwörterMinimalinvasiv ; Gluetalinsuffizienz ; Luxation ; Gelenkstabilität ; Chirurgie
- 刊名：Der Orthopäde
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：46
- 期：1
- 页码：18-24
- 全文大小：790KB
- 刊物主题：Orthopedics; Chiropractic Medicine; Conservative Orthopedics; Surgical Orthopedics; Sports Medicine; Traumatic Surgery;
- 出版者：Springer Medizin
- ISSN：1433-0431
- 卷排序：46
文摘
There are a large number of different approaches to the hip joint. Several conventional and minimally invasive portals exist and numerous technical variations with different instrument sets are available. All approaches can be regarded as standard and can be utilized lege artis. The main differences between approaches are their potential to preserve muscles and avoid damage which would slow down rehabilitation and mobilization. In the elderly the preservation of abductor function is, in the authors’ opinion, of utmost importance. A well-functioning gluteal system provides a limp-free gait, supports joint stability and reduces the probability of dislocations. The direct anterior approach has some advantages; however, minimally invasive approaches should be used with care. Surgical experience, experience with a specific approach and the availability of specialized instruments as well as sufficient training are mandatory for a successful performance. A surgeon should always choose the approach with which he has most experience.