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Chronische knöcherne Instabilitäten des Ellenbogengelenkes

Chronic bony instability of the elbow joint

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Zusammenfassung

Die hohe Stabilität des Ellenbogengelenks beruht auf der Kongruenz seiner knöchernen Gelenkpartner in Zusammenspiel mit den weichteiligen Stabilisatoren. Aufseiten der knöchernen Stabilität besitzt der Processus coronoideus eine Schlüsselfunktion als primärer, knöcherner Stabilisator. Zusammen mit dem Koronoid unterstützt der Radiuskopf als sekundärer Stabilisator die posterolaterale Rotationsstabilität und wirkt mit dem medialen Kollateralband wesentlich gegenüber Valgusstress. Substanzdefekte der knöchernen Stabilisatoren können in chronischer Dezentrierung und komplexen Instabilitäten des Ellenbogengelenkes resultieren, die aufwendige gelenkrekonstruktive Eingriffe erforderlich machen. Die Rekonstruktion knöcherner Stabilisatoren erfolgt nicht isoliert: Insuffizienzen weichteiliger Stabilisatoren müssen mit beurteilt und adressiert werden. Die Rekonstruktionsmöglichkeiten bei chronischer knöcherner Instabilität des Ellenbogengelenkes sind Inhalt dieser Übersicht.

Abstract

The high stability of the elbow joint is provided by the congruent articular surfaces in combination with soft tissue stabilizers. The main osseous contributor of elbow stability is the coronoid, which is therefore referred to as a primary stabilizer. The radial head as a secondary stabilizer together with the medial collateral ligament assures valgus stability and together with the coronoid it assures posterolateral stability. Insufficiency of the osseous stabilizers may lead to difficulties in the treatment of chronic dislocation and complex instability. Thereby reconstruction of the osseous constraints of the elbow joint is not performed in isolation from addressing insufficient soft-tissue stabilizers. Bony stabilizers and reconstructional procedures are discussed in this review.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik, BG Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland

    J. Geßmann, M. Königshausen, T. A. Schildhauer & D. Seybold

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  1. J. Geßmann
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  2. M. Königshausen
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  3. T. A. Schildhauer
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  4. D. Seybold
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Correspondence to D. Seybold.

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Interessenkonflikt

J. Geßmann, M. Königshausen, T. A. Schildhauer und D. Seybold geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Geßmann, J., Königshausen, M., Schildhauer, T.A. et al. Chronische knöcherne Instabilitäten des Ellenbogengelenkes. Orthopäde 45, 822–831 (2016). https://doi.org/10.1007/s00132-016-3325-y

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