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Primärer endoprothetischer Ellbogengelenkersatz bei komplexen intraartikulären distalen Humerusfrakturen

Primary total elbow replacement for complex intra-articular distal humerus fractures

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Zusammenfassung

Hintergrund

Die Osteosynthese multifragmentärer intraartikulärer Frakturen des distalen Humerus führt bei Patienten fortgeschrittenen Alters mit osteoporotischem Knochen häufig nicht zu befriedigenden Ergebnissen.

Methode

Im Zeitraum von 12/2001 bis 01/2008 wurden 12 Patienten (Durchschnittsalter 81±9 Jahre) mit einer Ellbogenprothese (Typ Coonrad-Morrey, Fa. Zimmer, USA) bei einer C-Fraktur des distalen Humerus versorgt.

Das Follow-up mit klinischer und radiologischer Kontrolle erfolgte nach durchschnittlich 28±17 Monaten.

Ergebnisse

Der Mayo-Score zeigte mit einem Mittelwert von 81±9 von 100 ein gutes funktionelles Ergebnis. DASH- und SECEC-Score ergaben ein zufrieden stellendes Resultat (43±8 bzw. 68±7 Punkte). Die durchschnittliche erreichte Beweglichkeit betrug 120-33-0°. Radiologisch waren in 4 Fällen heterotope Ossifikationen sowie in 4 Fällen nichtsymptomatische Lysesäume zu verzeichnen.

Schlussfolgerung

Die primäre Implantation einer Ellbogenprothese bei komplexen intraartikulären distalen Humerusfrakturen führt bei Patienten fortgeschrittenen Alters zu guten funktionellen Ergebnissen und stellt eine Alternative zur Osteosynthese dar.

Abstract

Introduction

Open reduction and internal fixation of multifragmentary intra-articular fractures of the distal humerus often do not provide satisfactory results in elderly patients with osteoporosis.

Method

From December 2001 to January 2008 a total elbow arthroplasty (Coonrad-Morrey, Zimmer, USA) was performed on 12 patients (average age 81±9  ears) who presented with a type C distal humeral fracture.

The mean time of follow-up with clinical and radiological assessment was 28±17 months.

Results

The Mayo score showed a good functional result with an average of 81±9 out of 100. DASH and SECEC scores showed a fair result with respect to elbow function (43±8 and 68±7 points, respectively). The average range of motion of all patients was 120-33-0°. Heterotopic ossifications were found by X-ray examination in 4 cases and asymptomatic radiolucent lines in 4 cases.

Conclusion

Primary total elbow arthroplasty for complex intra-articular distal humerus fractures in elderly patients has good functional results and is an alternative to osteosynthesis.

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Authors and Affiliations

  1. Chirurgisch-Orthopädische Klinik, Regionalspital Surselva, Ilanz, Schweiz

    E. Kraus

  2. Klinik für Orthopädie und Traumatologie, Bürgerspital Solothurn, Solothurn, Schweiz

    R. Harstall

  3. Abteilung Handchirurgie, DRK-Klinik Baden-Baden, Baden-Baden, Deutschland

    N. Borisch

  4. Abteilung Orthopädie/Traumatologie, St. Claraspital AG, Kleinriehenstr. 30, CH-4058, Basel, Schweiz

    D. Weber

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  1. E. Kraus
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  3. N. Borisch
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  4. D. Weber
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Correspondence to D. Weber.

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Kraus, E., Harstall, R., Borisch, N. et al. Primärer endoprothetischer Ellbogengelenkersatz bei komplexen intraartikulären distalen Humerusfrakturen. Unfallchirurg 112, 692–698 (2009). https://doi.org/10.1007/s00113-009-1660-8

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