{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:49:09Z","timestamp":1768877349150,"version":"3.49.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung Bei der Behandlung von Verletzungen der oberen Halswirbels\u00e4ule hat das semikonservative Verfahren des Halofixateurs heute eine untergeordnete Rolle. \u00c4ltere Studien aus den 2000er-Jahren zeigten unbefriedigende Durchbauungsraten sowie hohe Komplikationsraten. Jedoch resultiert aufgrund aktueller Daten zur Therapieeffektivit\u00e4t derzeit eine kontroverse Literaturlage. Ziel der Arbeit ist es, eigene Erfahrungen und Ergebnisse der Behandlung der aktuellen Literatur gegen\u00fcberzustellen und einen kl\u00e4renden Beitrag zur Rolle des Halofixateurs zu leisten.<\/jats:p><jats:p>\n          Material und Methoden In einer monozentrischen retrospektiven Kohortenstudie wurden Patienten mit instabilen Verletzungen der axialen Halswirbels\u00e4ule untersucht, die im Halofixateur ausbehandelt werden sollten. Anhand der elektronischen Krankenakte wurden individuelle Variablen (Geschlecht, Alter, Nebenerkrankungen, Charlson Comorbidity Index) und Therapiekennwerte (Dauer der Behandlung, Konsolidierungszustand, Komplikationen) erfasst. Die Verletzungen wurden aufgrund der CT-Daten zum Unfallzeitpunkt und zum Behandlungsende anhand g\u00e4ngiger Klassifikationssysteme eingeteilt und hinsichtlich der Konsolidierungsrate beurteilt. M\u00f6gliche Einflussfaktoren auf die kn\u00f6cherne Konsolidierung sowie Komplikationen wurden statistisch analysiert.<\/jats:p><jats:p>\n          Ergebnisse Insgesamt 54 Patienten\/-innen entsprachen den Einschlusskriterien. Die Behandlungsdauer lag im Median bei 83 Tagen. Die h\u00e4ufigsten Verletzungen waren die isolierte Atlasfraktur Typ III (7; 13%) und die isolierte Densfraktur Typ III (24; 44%). Eine kn\u00f6cherne Konsolidierung konnte in 34 F\u00e4llen (63%) und eine straffe Pseudarthrose in 13 F\u00e4llen (24%) nachgewiesen werden. In 6 F\u00e4llen (11%) wurde sekund\u00e4r eine operative Stabilisierung durchgef\u00fchrt. Isolierte Atlasfrakturen Typ III und Densfrakturen Typ III wiesen mit 86% bzw. 92% sehr hohe Konsolidierungsraten auf. In den Subgruppen von Patienten\/-innen \u00fcber 65 Jahren bzw. mit einem CCI\u00a0\u2265\u00a04 fanden sich h\u00e4ufiger instabile Pseudarthrosen. Als Komplikationen traten Pin-Infektionen (6%), Pin-Dislokationen (9%) und Druckulzerationen durch die Haloweste (6%) auf. Kardiopulmonale Komplikationen traten nicht auf. Kein Patient verstarb.<\/jats:p><jats:p>\n          Diskussion Es zeigten sich f\u00fcr Atlasfrakturen Typ III sowie Densfrakturen Typ III gute Raten f\u00fcr die kn\u00f6cherne Konsolidierung, die mit den Angaben in der Literatur korrelieren. Densfrakturen Typ II (isoliert und kombiniert) und Atlasfrakturen Typ III in Kombination mit Densfrakturen zeigten ein schlechteres radiologisches Outcome, das auch im Vergleich zur Literatur unbefriedigend ist. Die Raten f\u00fcr verfahrensspezifische Komplikationen waren relativ niedrig. Insbesondere Arbeiten aus den letzten Jahren konnten sehr gute Raten f\u00fcr die kn\u00f6cherne Konsolidierung und niedrige Komplikationsraten f\u00fcr die Behandlung von Atlas- und \/oder Densfrakturen mit dem Halofixateur nachweisen, die durch unsere Ergebnisse best\u00e4tigt werden. Im Kontrast dazu wird allerdings \u00fcber eine deutlich h\u00f6here kardiale\/respiratorische Komplikationsrate berichtet, als sie im eigenen Patientenkollektiv auftrat.<\/jats:p>","DOI":"10.1055\/a-1957-6053","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T23:38:37Z","timestamp":1674171517000},"page":"199-210","source":"Crossref","is-referenced-by-count":2,"title":["Der Halofixateur zur Therapie von instabilen Frakturen der oberen Halswirbels\u00e4ule \u2013 eigene Erfahrungen und narratives Review"],"prefix":"10.1055","volume":"162","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8828-4092","authenticated-orcid":false,"given":"Florian Hans","family":"Brakopp","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie, BG Klinikum Bergmannstrost Halle, Halle, Deutschland"},{"name":"Klinik f\u00fcr Unfall-, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsklinikum Jena, Jena, 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