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Radiuskopfprothese – wann und welche?

Radial head prosthesis—when and which type?

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Der Radiuskopf ist Teil der komplexen Gelenkmechanik des Ellenbogengelenks. Frakturen des Radiuskopfes machen etwa ein Drittel aller Ellenbogenfrakturen aus. Ziel der Therapie von Radiuskopffrakturen ist der Erhalt der Gelenkkinematik sowie der Stabilität im Ellenbogengelenk. Um dies zu erreichen, sind bei dislozierten Radiuskopffrakturen eine offene Reposition und eine Osteosynthese notwendig. Lässt sich der Radiuskopf durch Osteosynthese nicht anatomisch rekonstruieren, besteht die Möglichkeit einer Radiuskopfresektion oder der Implantation einer Radiuskopfprothese. Der vorliegende Beitrag gibt eine Übersicht über die aktuellen Empfehlungen und die Evidenz zur Versorgung von Radiuskopffrakturen mittels Radiuskopfprothese. Es wird hierbei auf die Vor- und Nachteile der Implantation einer Radiuskopfprothese bei nicht rekonstruierbaren Radiuskopffrakturen, die alternative Möglichkeit der Radiuskopfresektion sowie die Limitationen der Radiuskopfprothese eingegangen.

Abstract

The radial head is part of the complex mechanics of the elbow joint. Radial head fractures make up approximately one third of all elbow fractures. The goal of treatment of radial head fractures is preservation of the elbow kinematics and to reconstitute the ligament stability of the elbow joint. An open reduction and internal fixation of dislocated radial head fractures is necessary to achieve this. If an anatomical reconstruction of the radial head by osteosynthesis is not possible due to fracture comminution, the treatment options consist of radial head resection or arthroplasty. This article gives an overview of the current recommendations and evidence for the treatment of radial head fractures with a radial head prosthesis. The advantages and disadvantages of radial head arthroplasty and radial head resection as well as their limitations in nonreconstructable radial head fractures are discussed.

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Correspondence to M. Schnetzke.

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T. Schalk, P.A. Grützner und M. Schnetzke geben an, dass kein Interessenkonflikt besteht.

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

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Schalk, T., Grützner, P.A. & Schnetzke, M. Radiuskopfprothese – wann und welche?. Trauma Berufskrankh 21, 16–23 (2019). https://doi.org/10.1007/s10039-019-0417-z

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  • DOI: https://doi.org/10.1007/s10039-019-0417-z

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