Universität zu Köln

Hackl, M., Muller, L. P., Leschinger, T. and Wegmann, K. (2017). Total elbow arthroplasty in traumatic and post-traumatic bone defects. Orthopade, 46 (12). S. 990 - 1001. NEW YORK: SPRINGER. ISSN 1433-0431

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Abstract

Total elbow arthroplasty is currently most commonly carried out due to acute trauma or post-traumatic conditions. Bone defects are often present and must be considered in the (pre-)operative workup. The use of semi-constrained prostheses with a systematic cementing technique through a triceps-on approach leads to satisfying clinical results, however, the outcome is worse when compared with rheumatic patients. Primary total elbow arthroplasty for complex distal humerus fractures in the elderly patient or secondary implantation following failed conservative treatment or osteosynthesis represent possible indications for (postaEuro)traumatic joint replacement. The condyles do not have to be reconstructed and the humerus can be shortened by 2-3 cm without sacrificing the functionality of the extensor apparatus. In the case of post-traumatic joint destruction and pronounced chronic instability following complex fractures of the proximal forearm - especially following terrible triad or Monteggia-like injuries - total elbow arthroplasty can be considered as a treatment option. The extensor apparatus must be reconstructed, and the implantation of the prosthesis must thus be combined with plate osteosynthesis of the ulna - if necessary. Chronic deformity should only be corrected as much as needed in order to avoid early aseptic loosening due to increased shearing forces and polyethylene wear. Massive bone loss is problematic and can be compensated with allografts or tumor prostheses. The results of these salvage procedures are less predictable, and complication rates increase significantly.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-209883
DOI:	10.1007/s00132-017-3493-4
Journal or Publication Title:	Orthopade
Volume:	46
Number:	12
Page Range:	S. 990 - 1001
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0431
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DISTAL HUMERAL FRACTURES; INTERNAL-FIXATION; REPLACEMENT; RECONSTRUCTION; REDUCTION; ALLOGRAFT Multiple languages Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20988