Gschwend N
Klinik Wilhelm Schulthess, Zürich.
Orthopade. 1987 Aug;16(4):340-7.
The condyles of the elbow are of utmost importance for the stability of this joint. This is particularly evident in cases where elbow prostheses had to be removed because of loosening or infection and where the condyles had been deliberately resected at the primary operation. In order to obtain a functional elbow with sufficient stability and mobility after removal of the prostheses, we can reconstruct the condyles by means of a large autologous bone graft, which we take from the midpart of the illiac bone. The fixation is done with a specially adapted plate rather than with screws. A few case examples with a longer follow-up are presented for whom the result was very gratifying. We also insist on the great importance of solid fixation of fractured condyles, particularly in cases of resection arthroplasty. Elbow arthrodeses should only be used where there is no chance of obtaining a sufficiently satisfactory result by means of an arthroplasty. In these rare cases, we have been using internal fixation with an adapted AO plate and the interposition of an autologous bone graft. In the future replantation of prostheses, possibly on neocondyles will become more important.
肘关节的髁对该关节的稳定性至关重要。这在因松动或感染而不得不取出肘关节假体以及在初次手术时故意切除髁的情况下尤为明显。为了在取出假体后获得具有足够稳定性和活动度的功能性肘关节，我们可以通过取自髂骨中部的大块自体骨移植来重建髁。固定采用特制适配的钢板而非螺钉。现展示一些随访时间较长的病例，其结果非常令人满意。我们还强调髁部骨折牢固固定的重要性，尤其是在切除关节成形术的病例中。肘关节融合术仅应在无法通过关节成形术获得足够满意结果的情况下使用。在这些罕见病例中，我们一直采用适配的AO钢板进行内固定并植入自体骨移植。在未来，假体可能在新髁上的再植入将变得更加重要。
