Skip to main content
Log in

Indikation zur Winkelstabilität am Ellenbogen

Indications for locked screw stabilization of the elbow

  • Übersichten
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Das komplexe Ellenbogengelenk trägt wesentlich zur Eigenständigkeit des alten Menschen bei. Eine Fraktur in ihm stellt daher nicht nur für den Chirurgen eine ernsthafte Herausforderung dar. Bei der Versorgung müssen im Gegensatz zum jüngeren Patienten Faktoren wie ein reduzierter Allgemeinzustand, Grunderkrankungen, eine häufigere Gelenkbeteiligung und gerade bei Frauen eine vorliegende Osteoporose/Osteopenie berücksichtigt werden. Dennoch gelten nahezu dieselben Konzepte wie beim jüngeren Patienten. Unterschiede ergeben sich im Einsatz von winkelstabilen Implantaten im osteoporotischen Knochen oder bei der Implantation einer primären Totalendoprothese bei komplexen distalen Humerusfrakturen mit mehrfragmentärer Gelenkbeteiligung. Eine Ruhigstellung wird vom älteren Patienten in der Regel nur schlecht toleriert, und so sollte gerade wegen des Alters und vor dem Hintergrund guter Ergebnisse in jüngsten Studien eine Osteosynthese mit hoher Primärstabilität angestrebt werden.

Abstract

The elbow joint plays an important role in the independence of elderly people. Fractures in this complex joint therefore represent a serious challenge not only for surgeons. In contrast to younger patients, factors such as a reduced general physical condition, underlying diseases, more frequent joint involvement and especially for women, the presence of osteoporosis and/or osteopenia, must be taken into consideration when deciding on the treatment modality. However, practically the same concepts apply as with younger patients. Differences exist in the use of locked screw plate implants for osteoporotic bones or implantation of a primary total prosthesis for complex distal humeral fractures with multiple fragmentary joint involvement. Immobilization is normally poorly tolerated by elderly patients and therefore osteosynthesis with high primary stability should be strived for, particularly due to the age and considering the good results achieved in recent studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2

Literatur

  1. Bauer GJ, Hoellen I (1997) Die distale intrartikuläre Humerusfraktur. Diagnostik, Operationstechnik und Ergebnisse. Aktuelle Traumatol 27:125–131

    Google Scholar 

  2. Buijze GA, Blankevoort L, Tuijthof GJ et al (2010) Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg 130:459–464

    Article  PubMed  Google Scholar 

  3. Edwards SG, Martin BD, Fu RH et al (2011) Comparison of olecranon plate fixation in osteoporotic bone: do current technologies and designs make a difference? J Orthop Trauma 25:306–311

    Article  PubMed  Google Scholar 

  4. Erturer RE, Sever C, Sonmez MM et al (2011) Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. J Shoulder Elbow Surg 20:449–454

    Article  PubMed  Google Scholar 

  5. Josten C, Lill H (2002) Ellenbogenverletzungen. Steinkopff, Darmstadt

  6. Korner J, Lill H, Muller LP et al (2003) The LCP-concept in the operative treatment of distal humerus fractures – biological, biomechanical and surgical aspects. Injury [Suppl 2] 34:B20–B30

  7. Korner J, Diederichs G, Arzdorf M et al (2004) A biomechanical evaluation of methods of distal humerus fracture fixation using locking compression plates versus conventional reconstruction plates. J Orthop Trauma 18:286–293

    Article  PubMed  Google Scholar 

  8. Korner J, Lill H, Muller LP et al (2005) Distal humerus fractures in elderly patients: results after open reduction and internal fixation. Osteoporos Int [Suppl 2] 16:S73–S79

  9. Lill H, Voigt C (2004) Injuries of the elbow joint. Chirurg 75:1037–1051

    Article  PubMed  CAS  Google Scholar 

  10. Palvanen M, Kannus P, Niemi S, Parkkari J (2010) Secular trends in distal humeral fractures of elderly women: nationwide statistics in Finland between 1970 and 2007. Bone 46(5):1355–1358

    Article  PubMed  Google Scholar 

  11. Perren SM (2002) Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 84:1093–1110

    Article  PubMed  Google Scholar 

  12. Reising K, Hauschild O, Strohm PC et al (2009) Stabilisation of articular fractures of the distal humerus: early experience with a novel perpendicular plate system. Injury 40:611–617

    Article  PubMed  CAS  Google Scholar 

  13. Rommens PM, Kuchle R, Schneider RU et al (2004) Olecranon fractures in adults: factors influencing outcome. Injury 35:1149–1157

    Article  PubMed  CAS  Google Scholar 

  14. Schatzker J (1987) Olecranon fractures. In: Schatzker J, Tile M (Hrsg) The rationale of operative fracture care. Springer, Berlin Heidelberg New York, S 80–87

  15. Schmidt-Horlohe K, Bonk A, Wilde P et al (2010) Functional results after osteosynthesis of the distal humerus fracture with an anatomically precontoured, angular-stable double plate system. Z Orthop Unfall 148:300–308

    Article  PubMed  CAS  Google Scholar 

  16. Schuster I, Korner J, Arzdorf M et al (2008) Mechanical comparison in cadaver specimens of three different 90-degree double-plate osteosyntheses for simulated C2-type distal humerus fractures with varying bone densities. J Orthop Trauma 22:113–120

    Article  PubMed  Google Scholar 

  17. Siebenlist S, Torsiglieri T, Kraus T et al (2010) Comminuted fractures of the proximal ulna – preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury 41:1306–1311

    Article  PubMed  CAS  Google Scholar 

  18. Windolf M, Maza ER, Gueorguiev B et al (2010) Treatment of distal humeral fractures using conventional implants. Biomechanical evaluation of a new implant configuration. BMC Musculoskelet Disord 11:172

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Hepp.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hepp, P., Josten, C. Indikation zur Winkelstabilität am Ellenbogen . Trauma Berufskrankh 13 (Suppl 1), 117–121 (2011). https://doi.org/10.1007/s10039-011-1779-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10039-011-1779-z

Schlüsselwörter

Keywords

Navigation