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Chronische mediale Ellenbogeninstabilität – aktuelle Datenlage

Chronic medial elbow instability—status quo

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Zusammenfassung

Eine chronische Valgusinstabilität kann durch ein akutes Trauma, eine iatrogene Schädigung oder durch Überbelastungen verursacht werden. Insbesondere bei Über-Kopf- und Wurfsportarten ist der Ellenbogen hohen Valguskräften ausgesetzt, die durch repetitive Überlastungen das mediale Kollateralband sukzessive schwächen. Die zunehmende Valgusinstabilität des Ellenbogens führt zu zunehmenden Kompressionskräften im radialen Kompartiment, was zu erheblichen Knorpelschäden führen kann. Durch das verstärkte Anschlagen des Olecranons am medialen Rand der Fossa olecrani kommt es hier zur typischen Osteophytenbildung und freien Gelenkkörpern. Der vorliegende Artikel befasst sich mit den Grundlagen und der Diagnostik der chronischen Valgusinstabilität und diskutiert konservative und operative Therapieoptionen anhand der aktuellen Literatur.

Abstract

Chronic valgus instability can result from acute trauma, iatrogenic injury or overuse. Especially the overhead athlete’s and thrower’s elbow experience high valgus loads. Repetitive microtraumata weaken the medial collateral ligament. Increasing valgus instability leads to increasing compressing forces in the radial column which may lead to severe cartilage damage. Contact stress of the olecranon and medial fossa cause typical osteophyte formations and loose bodies. This article reviews the fundamentals and diagnostics of chronic valgus instability. Nonoperative and operative therapy options are discussed in the light of the current literature.

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Authors and Affiliations

  1. Arcus Sportklinik, ARCUS Kliniken, Rastatter Str. 17–19, 75179, Pforzheim, Deutschland

    K. J. Burkhart, M. M. Schneider, R. Nietschke & B. Hollinger

  2. Universität zu Köln, Köln, Deutschland

    K. J. Burkhart

  3. Universität Witten/Herdecke, Witten, Deutschland

    M. M. Schneider

  4. Unfall‑, Hand- und Ellenbogenchirurgie, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Deutschland

    M. Hackl & L. P. Müller

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  1. K. J. Burkhart
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  3. M. Hackl
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Correspondence to K. J. Burkhart.

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Interessenkonflikt

K.J. Burkhart, M.M. Schneider, M. Hackl, R. Nietschke, L.P. Müller und B. Hollinger geben an, dass kein Interessenkonflikt besteht.

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

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Burkhart, K.J., Schneider, M.M., Hackl, M. et al. Chronische mediale Ellenbogeninstabilität – aktuelle Datenlage. Obere Extremität 14, 33–38 (2019). https://doi.org/10.1007/s11678-019-0504-6

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