Weber O, Burger C, Stein G, Gravius S, Wirtz D C, Pennekamp P H, Kraft C N, Müller M
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
Unfallchirurg. 2010 Dec;113(12):977-83. doi: 10.1007/s00113-010-1899-0.
Posttraumatic arthrosis or rheumatoid arthritis located at the elbow, in particular at the humero-ulnar joint will probably not occur in increasing numbers in the future due to new antirheumatic medications and modern implants. However, the demographic development with an increase of the geriatric population and the typical physical changes is evident. Due to osteoporosis with a resulting poor bone quality severe fracture patterns may occur at the site of the distal humerus after a simple collapse. The usual surgical aim consisting of an exact anatomic reduction may be impossible to achieve by applying the standard operative treatment. Several studies have proven that a prosthetic replacement of such a severely damaged elbow is a viable solution for elderly people. A mobile, pain-free and stable elbow joint promotes a fast recovery of the patient with a quick return to former activities. Nevertheless, elbow prostheses cannot withstand great strains and the surgeon has to identify those fractures which require a prosthetic replacement. The surgical implantation procedure requires an adequate knowledge of both elbow anatomy and prosthetic options.
由于新型抗风湿药物和现代植入物的出现，创伤后关节炎或位于肘部（特别是肱尺关节）的类风湿性关节炎在未来可能不会越来越多地出现。然而，老年人口增加以及典型身体变化的人口发展趋势是明显的。由于骨质疏松导致骨质质量差，在简单跌倒后，肱骨远端部位可能会出现严重骨折类型。通过应用标准手术治疗，通常由精确解剖复位组成的手术目标可能无法实现。多项研究证明，对于老年人来说，对如此严重受损的肘部进行假体置换是一种可行的解决方案。一个活动自如、无痛且稳定的肘关节能促进患者快速康复并迅速恢复以前的活动。然而，肘关节假体无法承受巨大压力，外科医生必须识别出那些需要进行假体置换的骨折。手术植入过程需要对肘部解剖结构和假体选择有充分的了解。
