[Fracture endoprosthesis of distal humerus fractures].
The treatment of choice for fractures of the distal humerus is double plate osteosynthesis. Due to anatomical preshaped angle stable plates the primary stability and management of soft tissues has been improved. However, osteoporotic comminuted fractures in the elderly are often not amenable to stable osteosynthesis and total elbow arthroplasty has been established as an alternative therapy. Although complication rates have been reduced, complications of total elbow arthroplasty are still much more frequent than in total hip replacement. Furthermore, patients are advised not to exceed a weight bearing of 5 kg. Therefore, the indications for elbow arthroplasty must be evaluated very strictly and should be reserved for comminuted distal humeral fractures in the elderly with poor bone quality that are not amenable to stable osteosynthesis or for simple fractures in cases of preexisting symptomatic osteoarthritis. This article introduces and discusses modern concepts of elbow arthroplasty, such as modular convertible prosthesis systems, hemiarthroplasty and radial head replacement in total elbow arthroplasty.
Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Kerpener Straße 62, Köln, Germany. lars.mueller@uk-koeln.de
L P
LP
Müller
K
K
Wegmann
K J
KJ
Burkhart
D057929:Arthroplasty, Replacement, Elbow / Q000295:instrumentation* / Q000379:methods*; D004551:Elbow Joint / Q000601:surgery*; D058569:Elbow Prosthesis; D006801:Humans; D006811:Humerus / Q000293:injuries* / Q000601:surgery*; D011474:Prosthesis Design; D000092464:Elbow Injuries