Indikation Zur Operativen Frakturenbehandlung: Experimentalchirurgische Und Klinische Aspekte
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Fehlergebnisse bei operativer Frakturenbehandlung entstehen erfahrungsgemat: . zu einem betrachtlichen Tell durch Indikationsfehler. Die vorliegende Unter- suchung will diese Problematik eingrenzen und durchschaubarer machen, denn empirisch-klinische Daten, meist retrospektiven Charakters, reichen offensichtlich zur Indikationsstellung nicht in allen Fallen aus. Es ist die Frage, ob prospektive oder prognostische Kriterien erarbeitet werden konnen, denn ein derartig theoretisch fundiertes Konzept ware leichter diskutabel als rein empirische Daten und iiberhaupt an jedem Ort zu jeder Zeit leichter nachvollziehbar . Grundgedanke der vorliegenden Arbeit ist, Indikation unter einem operatio- nalen Aspekt als Entscheidungsprozet: . darzustellen, welcher die klinische Situation in ihrer Gesamtheit sieht und dementsprechend ganz unterschied- liche Dimensionen wie klinische Empirie, Pathophysiologie, Krankenhaus- organisation und am Rande auch ethische Fragen abdeckt. Die Intention dabei kann aber nicht sein, einen erschOpfenden und invarianten Abrit: . der Indikationsstellung nach Art von Kochrezepten zu geben, - dies geht schon nicht aus wissenschaftstheoretischen Griinden, da in der klinischen Praxis keine Situation der anderen vollstandig gleicht, womit das Streben nach Vollstandigkeit zur ins Uferlose gehenden Sisyphosarbeit wiirde. Vielmehr wird der Versuch untemommen, das interdisziplinare Problem: Indikation unter dem Blickwinkel eines systemtheoretisch analysierbaren Behandlungsentwurfes in die Diskussion zu bringen. Es ist beabsichtigt, wesentliche Aspekte des Indikationsbegriffes herauszugreifen, mit denen im praktischen Einzelfall ein Behandlungsplan gestaltet werden konnte. Bei der Erarbeitung der vorliegenden Ergebnisse wurde mir von vielen Seiten Unterstiitzung zuteil, mein Dank gilt Frau G. Bach, Herrn Prof. K.H. Booz, Frau T. Felsing, Herm Prof. V. Freitag und seinen Mitarbeitem, Herm Prof.
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