Leschinger T, Hackl M, Lanzerath F, Krane F, Harbrecht A, Wegmann K, Müller L P
Unfall‑, Hand- und Ellenbogenchirurgie, Universitätsklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
Orthopädische Chirurgie München (OCM), München, Deutschland.
Unfallchirurgie (Heidelb). 2022 Sep;125(9):699-708. doi: 10.1007/s00113-022-01215-7. Epub 2022 Jul 14.
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.
对于老年肱骨远端骨折患者,通过考虑骨折的形态特征、骨质以及患者的个体需求和变量,植入全肘关节假体可取得良好至非常好的临床效果。最常用的设计是骨水泥固定的半限制连接式全肘关节假体。非连接式假体设计和半关节成形术需要完整或可充分重建的肌肉韧带结构或髁以及保留或置换的桡骨头。必须考虑全肘关节假体术后的推荐体重限制以及潜在的术中和术后并发症,并与患者进行讨论。在初次保守治疗后,例如骨折情况禁忌手术、持续疼痛和功能受限的情况下,二次全肘关节置换术也是可行的。本文概述了该技术及合适的适应症。