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Trauma-assoziierte Ellenbogenendoprothetik

Trauma-associated elbow arthroplasty

  • Leitthema
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Trauma und Berufskrankheit

Zusammenfassung

Das Ellenbogengelenk ist ein hochkomplexes Gelenk, das durch seine 3 Gelenkanteile eine wichtige Funktionseinheit in der Bewegungskette der oberen Extremität darstellt. Etwa 5 % der Frakturen beim geriatrischen Patienten sind intraartikuläre distale Humerusfrakturen. Der Goldstandard bezüglich der Therapie der oben genannten Verletzung ist weiterhin die winkelstabile Plattenosteosynthese. In seltenen, nicht rekonstruktionsfähigen Situationen oder bei schwerwiegenden Komorbiditäten, die das Operationsergebnis kompromittieren können, haben sich die primäre Implantation einer Ellenbogentotalprothese im höheren Alter als auch die sekundäre Implantation bei posttraumatischen Zuständen etabliert. Diese Übersichtsarbeit beinhaltet Empfehlungen unter Berücksichtigung der aktuellen Studienlage zur Versorgung von nichtrekonstruierbaren distalen Humerusfrakturen oder posttraumatischen Zuständen mittels Ellenbogenhemi- und Ellenbogentotalendoprothesen. Sie soll ein Leitfaden für die Indikationsstellung, das präoperative und operative Vorgehen, die Nachbehandlung sowie die Wahl des geeigneten Implantates sein und als Entscheidungshilfe dienen.

Abstract

The elbow joint is a highly complex functional unit that due to its three joint components acts as an important link in the movement chain of the upper extremity. Intra-articular distal humeral fractures make up approximately 5% of the fractures in the geriatric population. Osteosynthetic reconstruction via double locking plates is the gold standard for this type of fracture; however, in rare cases if reconstruction is not possible due to the severity of the fracture or other compromising comorbidities, total elbow arthroplasty has become established as an adequate primary treatment in advanced age as well as secondary implantation in posttraumatic situations. This review article contains recommendations on the treatment of nonreconstructable distal humeral fractures or posttraumatic situations with elbow hemiprostheses and total elbow endoprostheses. This article presents guidelines for assessing the indications, reflects the preoperative work-up and planning, helps in finding the appropriate implant and reviews the current literature for trauma-related total elbow arthroplasty.

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Correspondence to S. M. Dettmer.

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S.M. Dettmer und R. Hoffmann geben an, dass kein Interessenkonflikt besteht.

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

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Dettmer, S.M., Hoffmann, R. Trauma-assoziierte Ellenbogenendoprothetik. Trauma Berufskrankh 21, 9–15 (2019). https://doi.org/10.1007/s10039-019-0418-y

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  • DOI: https://doi.org/10.1007/s10039-019-0418-y

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