Loading
Medizinische Universität Graz    

Meine Abschlussarbeiten - Publikationen

Diplomarbeit - Detailansicht
Wichtigste Meldungen anzeigenMeldungsfenster schließen
Bibliografische Informationen
 Operative Therapie bei hypermobilem Ehlers-Danlos-Syndrom (hEDS): Systematische Darstellung perioperativer Risiken unter besonderer Berücksichtigung handchirurgischer Eingriffe  
 Introduction: Hypermobile Ehlers-Danlos syndrome (hEDS) is a hereditary connective tissue disorder characterized by generalized joint hypermobility, chronic musculoskeletal pain, joint instability, and systemic manifestations of connective tissue dysfunction. Diagnosis is based on clinical criteria. Due to altered mechanical properties of the connective tissue, surgical procedures in patients with hEDS may be associated with specific perioperative challenges. The aim of this thesis was to systematically summarize the available scientific literature on surgical procedures in patients with hEDS. The focus was placed on perioperative complications and risks in orthopedic surgery, as well as on surgical interventions of the hand and hand- or wrist-related manifestations in patients with hEDS.

Methods: This thesis is based on a systematic literature search and narrative synthesis. Publications were included if they addressed surgical procedures, perioperative risks, intraoperative or postoperative complications, or specific hand surgical aspects in hEDS. Due to small sample sizes, heterogeneous study designs, and inconsistent outcome parameters, the results were summarized narratively. For the hand surgery section, the included publications were additionally analyzed descriptively according to study design, anatomical focus, and type of treatment.

Results: The findings show that the available evidence on surgical interventions in hEDS is limited and heterogeneous. Preoperatively, careful patient selection, individualized indication, realistic informed consent, and the exhaustion of conservative treatment options are essential. Intraoperatively, relevant factors include tissue fragility, technical difficulties during dissection and suturing, bleeding or hematoma formation, anesthetic considerations, and careful patient positioning. Postoperatively, impaired wound healing, abnormal scarring, pain, autonomic dysfunction, prolonged rehabilitation, and potential instability of reconstructed structures have been described. In the context of hand surgery, reported manifestations mainly include joint instability and subluxations of the thumb carpometacarpal joint and the wrist. The included publications describe both conservative and surgical treatment approaches. Surgical procedures may lead to functional improvement and pain reduction in selected cases; however, the strength of the available evidence remains limited due to small patient numbers, heterogeneous indications, and the lack of standardized outcome measures.

Conclusion: Surgical procedures in patients with hEDS require individualized, interdisciplinary, and cautious planning. Surgery should be considered only after careful risk-benefit assessment and after conservative measures have been exhausted. In hand surgery, there is a particular need for prospective studies, standardized outcome parameters, and long-term follow-up data in order to establish more reliable recommendations for the surgical management of patients with hEDS.  
 hypermobiles Ehlers-Danlos-Syndrom; Handchirurgie; perioperative Risiken  
 
 –  
 Humangenetik
Autorinnen*Autoren / Co-Autorinnen*Co-Autoren
  Glantschnig, Caroline
Betreuende Einrichtung / Studium
  Diagnostik & Forschungsinstitut für Humangenetik
 UO 202 Humanmedizin  
Betreuung / Beurteilung
  Juch, Herbert; Priv.-Doz. Dr.med.univ.