[Elbow prosthesis after acute fractures : Indications and technique].
Ellenbogenprothese nach akuten Frakturen : Indikation und Technik.
Humeral fractures
Joint instability
Periprosthetic fractures
Prosthesis design
Prosthesis implantation
Journal
Unfallchirurgie (Heidelberg, Germany)
ISSN: 2731-703X
Titre abrégé: Unfallchirurgie (Heidelb)
Pays: Germany
ID NLM: 9918384886306676
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
27
06
2022
pubmed:
15
7
2022
medline:
30
8
2022
entrez:
14
7
2022
Statut:
ppublish
Résumé
Good to very good clinical results can be achieved in older patients with the implantation of a total elbow prosthesis in cases of distal humeral fractures by taking the morphological features of the fractures, the bone quality as well as the individual patient requirements and variables into account. The most commonly used design is the cemented semiconstrained linked total elbow endoprosthesis. The unlinked prosthesis design and hemiarthroplasty require intact or adequately reconstructable musculoligamentous structures or condyles and a preserved or replaced radial head. The recommended weight limit after total elbow prosthesis as well as potential intraoperative and postoperative complications must be considered and discussed with the patients. A secondary total elbow arthroplasty is also possible after primary conservative treatment approaches, e.g., in the case of contraindicated surgery in the fracture situation, persistent pain and functional restrictions. This article provides an overview of the technique and the appropriate indications. Unter Beachtung der Frakturmerkmale, der Knochenqualität sowie der individuellen Ansprüche und Patientenvariablen kann die Frakturendoprothetik am Ellenbogen gute bis sehr gute klinische Ergebnisse beim älteren Patientenkollektiv erzielen. Das meist verwendete Design ist die zementierte, gekoppelte („semiconstrained“) Totalendoprothese. Das „ungekoppelte Prothesendesign“ und die Hemiendoprothetik setzen intakte oder gut rekonstruierbare muskuloligamentäre Strukturen bzw. Kondylen sowie einen erhaltenden oder ersetzten Radiuskopf voraus. Die empfohlene Gewichtslimitierung bei der Totalendoprothese sowie potenzielle intra- und postoperative Komplikationen sind zu bedenken und mit den Patienten zu besprechen. Auch eine sekundäre Ellenbogenprothese nach primär konservativem Therapieansatz beispielsweise bei kontraindizierter Operation in der Fraktursituation, anhaltenden Schmerzen und Funktionseinschränkungen ist möglich. Der Beitrag gibt einen Überblick über die Technik und die entsprechenden Indikationen.
Autres résumés
Type: Publisher
(ger)
Unter Beachtung der Frakturmerkmale, der Knochenqualität sowie der individuellen Ansprüche und Patientenvariablen kann die Frakturendoprothetik am Ellenbogen gute bis sehr gute klinische Ergebnisse beim älteren Patientenkollektiv erzielen. Das meist verwendete Design ist die zementierte, gekoppelte („semiconstrained“) Totalendoprothese. Das „ungekoppelte Prothesendesign“ und die Hemiendoprothetik setzen intakte oder gut rekonstruierbare muskuloligamentäre Strukturen bzw. Kondylen sowie einen erhaltenden oder ersetzten Radiuskopf voraus. Die empfohlene Gewichtslimitierung bei der Totalendoprothese sowie potenzielle intra- und postoperative Komplikationen sind zu bedenken und mit den Patienten zu besprechen. Auch eine sekundäre Ellenbogenprothese nach primär konservativem Therapieansatz beispielsweise bei kontraindizierter Operation in der Fraktursituation, anhaltenden Schmerzen und Funktionseinschränkungen ist möglich. Der Beitrag gibt einen Überblick über die Technik und die entsprechenden Indikationen.
Identifiants
pubmed: 35833974
doi: 10.1007/s00113-022-01215-7
pii: 10.1007/s00113-022-01215-7
doi:
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
699-708Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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