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Endoprothetik der akuten Radiuskopffraktur

Endoprosthetics of acute radial head fractures

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Zusammenfassung

Die Radiuskopfprothese stellt die Therapie der Wahl für nicht rekonstruierbare Radiuskopffrakturen dar. Solide Prothesen aus Metall oder Pyocarbon können unabhängig vom Design oder Verankerungsoptionen die Valgusstabilität des Ellenbogens wiederherstellen. Kurz- und mittelfristige Ergebnisse zeigen überwiegend gute und sehr gute Ergebnisse, ohne dass bisher wesentliche Unterschiede zwischen den verschiedenen Prothesenphilosophien ausgemacht werden können. Wichtig für das Erreichen eines guten Ergebnisses sind die korrekte Implantationstechnik unter Vermeidung eines „Overstuffing“ und die korrekte Einschätzung der ligamentären Begleitverletzungen. Dieser Artikel diskutiert die anatomischen und biomechanischen Grundlagen der Radiuskopfendoprothetik, die Operationstechnik und die radiologische Diagnostik des „Overstuffing“.

Abstract

Radial head arthroplasty is the treatment of choice for non-reconstructble radial head fractures. Solid prostheses made of metal or pyocarbon can restore valgus stability of the elbow independent of design or stem fixation. Short-term and mid-term results show mostly good to excellent results without any evident differences between the different prosthesis philosophies. In ordert to obtain good results it is important to implant the prosthesis correctly without overfilling and to judge concomitant ligament injuries correctly. This article discusses the anatomical and biomechanical basis of radial head arthroplasty as well as the surgical technique and radiological diagnosis of overfilling.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. K.J. Burkhart gibt eine Referententätigkeit für Arthex, Tornier, Medartis und Reisekostenübernahme durch Sryker an. K. Wegmann gibt eine Referententätigkeit für Medartis an. L.P. Müller gibt eine Referententätigkeit für Tornier, Medartis und Stryker an. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Burkhart, K., Wegmann, K., Ries, C. et al. Endoprothetik der akuten Radiuskopffraktur. Unfallchirurg 116, 698–707 (2013). https://doi.org/10.1007/s00113-013-2412-3

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