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Steifer und instabiler Ellenbogen – wie vorgehen?

Stiff and unstable elbow—how to proceed?

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Zusammenfassung

Ellenbogensteifen haben unterschiedliche Ursachen. Gerade die milden Steifen können Folgen von „Bagatellverletzungen“ oder nach Subluxationen sein. Etwaige Restinstabilitäten in der posterolateralen Richtung nach Arthrolyse können zu Rezidivsteifen führen. Eine zusätzliche Stabilisierung während der Arthrolyse oder zweizeitig kann daher sinnvoll sein. Dieser Artikel beschreibt die Pathologie und die entsprechenden Therapiemöglichkeiten.

Abstract

Elbow stiffness can have different underlying pathologies. Especially mild stiffness can be a result of minor trauma or subluxation. Persisting posterolateral rotatory instability (PLRI) following arthrolysis can also lead to recurrent stiffness. Additional stabilization during arthrolysis or a two-staged procedure may be useful. This article discusses the underlying pathology of PLRI and the various treatment options.

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Literatur

  1. Akai M, Shirasaki Y, Tateishi T (1993) Viscoelastic properties of stiff joints: a new approach in analyzing joint contracture. Biomed Mater Eng 3(2):67–73

    PubMed  CAS  Google Scholar 

  2. Cefo I, Eygendaal D (2011) Arthroscopic arthrolysis for posttraumatic elbow stiffness. J Shoulder Elbow Surg 20(3):434–439. https://doi.org/10.1016/j.jse.2010.11.018

    Article  PubMed  Google Scholar 

  3. Cohen MS, Schimmel DR, al Masuda Ket (2007) Structural and biochemical evaluation of the elbow capsule after trauma. J Shoulder Elbow Surg 16(4):484–490

    Article  PubMed  PubMed Central  Google Scholar 

  4. de Haan J, den Hartog D, Tuinebreijer WE et al (2010) Functional treatment versus plaster for simple elbow dislocations (FuncSiE): a randomized trial. BMC Musculoskelet Disord 11:263

    Article  PubMed  PubMed Central  Google Scholar 

  5. Evans PJ, Nandi S, Maschke S, Hoyen HA, Lawton JN (2009) Prevention and treatment of elbow stiffness. J Hand Surg Am 34:769–778

    Article  PubMed  Google Scholar 

  6. Geyer M, Schoch C, Harnoß T (2013) Therapiemöglichkeiten der chronischen ligamentären Ellenbogeninstabilität. Arthroskopie 26(3):197–206

    Article  Google Scholar 

  7. Hackl M, Beyer F, Wegmann K et al (2015) The treatment of simple elbow dislocation in adults. Dtsch Arztebl Int 112:311–319

    PubMed  PubMed Central  Google Scholar 

  8. Hackl M, Lappen S, Burkhart KJ et al (2015) Elbow positioning and joint insufflation substantially influence median and radial nerve locations. Clin Orthop Relat Res 473(11):3627–3634. https://doi.org/10.1007/s11999-015-4442-3

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jones GS, Savoie FH III (1993) Arthroscopic capsular release of flexion contractures. Arthroscopy 9(3):277–283

    Article  PubMed  CAS  Google Scholar 

  10. Jupiter JB, O’Driscoll SW, Cohen MS (2003) The assessment and management of the stiff elbow. Instr Course Lect 52:93–111

    PubMed  Google Scholar 

  11. Kay NR (2016) Arthrolysis of the posttraumatic stiff elbow. In: Surgery of the elbow: practical and scientific aspects, S 228–234

    Google Scholar 

  12. King GJ, Faber KJ (2000) Posttraumatic elbow stiffness. Orthop Clin North Am 31(1):129–143

    Article  PubMed  CAS  Google Scholar 

  13. Leschinger T, Müller I, Hackl M, Wegmann K (2016) Biomechanik des Ellenbogengelenkes. Orthop Unfallchir Up2date 11(03):159–176

    Article  Google Scholar 

  14. Leschinger T, Müller LP, Hackl M, Wegmann K (2016) Techniken der Arthrolyse am Ellenbogen. Obere Extremität 11:149–158

    Article  Google Scholar 

  15. Lichtenberg S (2014) Elbow contracture. Obere Extremität 9(3):163–171. https://doi.org/10.1007/s11678-014-0279-8

    Article  Google Scholar 

  16. Mansat P, Morrey BF (1998) The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am 80(11):1603–1615

    Article  PubMed  CAS  Google Scholar 

  17. Morrey BF, Askew LJ, Chao EY (1981) A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am 63(6):872–877

    Article  PubMed  CAS  Google Scholar 

  18. Morrey BF (1992) post-traumatic stiffness: distraction arthroplasty. Orthopedics 15(7):863–869

    PubMed  CAS  Google Scholar 

  19. O’Driscoll SW (2000) Classification and evaluation of recurrent instability of the elbow. Clin Orthop Relat Res 37(0):34–43

    Article  Google Scholar 

  20. Paul R, Chan R (2013) Nonsurgical treatment of elbow stiffness. J Hand Surg Am 38:2002–2004

    Article  PubMed  Google Scholar 

  21. Pederzini LA, Nicoletta F, Tosi M, Prandini M, Tripoli E, Cossio A (2014) Elbow arthroscopy in stiff elbow. Knee Surg Sports Traumatol Arthrosc 22(2):467–473. https://doi.org/10.1007/s00167-013-2424-0

    Article  PubMed  Google Scholar 

  22. Pettersen PM, Eriksson J, Mysreth et al (2016) Increased ROM and high patient satisfaction after open Arthrolysis: a follow up study of 43 patients with posttraumatic stiff elbows. BMC Musculoskelet Disord 17:74. https://doi.org/10.1186/s12891-016-0928-8

    Article  PubMed  PubMed Central  Google Scholar 

  23. Raiss P, Rettig O, Wolf S, Loew M, Kasten P (2007) Range of motion of shoulder and elbow inactivities of daily life in 3D motion analysis. Z Orthop Unfall 145(4):493–498

    Article  PubMed  CAS  Google Scholar 

  24. Ries C, Franke S, Dietrich F et al (2013) Transosseous refixation of the common extensor muscle tendons in chronic lateral epicondylitis with and without additional reconstruction of the LUCL—a retrospective evaluation of 101 patients. Z Orthop Unfall 151:296–301

    Article  PubMed  CAS  Google Scholar 

  25. Schoch C, Geyer M (2015) CRAP a new classification for chronic radial elbow pain and an algorithm for the operative treatment. Int J Sport Exerc Sci 2015(5):2

    Google Scholar 

  26. Siebenlist S, Lenich A, Imhoff AB (2016) Behandlungsalgorithmus Ellenbogenluxation. OUP 3:132–138. https://doi.org/10.3238/oup.2016.0132-0138

    Article  Google Scholar 

  27. Wijeratna MD, Ek ET, Hoy GA et al (2015) Use of a bone graft drill harvester to create the fenestration during arthroscopic ulnohumeral arthroplasty. Arthrosc Tech 4(5):e503–e505. https://doi.org/10.1016/j.eats.2015.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  28. Untersuchungstechniken des Ellenbogens und des Handgelenkes DVSE Komitee Ellbogen in Kooperation Publikation

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Authors and Affiliations

  1. St. Vinzenz Klinik Pfronten im Allgäu, Kirchweg 15, 87459, Pfronten, Deutschland

    C. Schoch & M. Geyer

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  1. C. Schoch
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  2. M. Geyer
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Correspondence to C. Schoch.

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C. Schoch und M. Geyer geben an, dass kein Interessenkonflikt besteht.

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

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Schoch, C., Geyer, M. Steifer und instabiler Ellenbogen – wie vorgehen?. Obere Extremität 13, 190–195 (2018). https://doi.org/10.1007/s11678-018-0457-1

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