Universität zu Köln

Schneider, M. M., Zimmermann, F., Hollinger, B., Zimmerer, A. and Burkhart, K. J. (2022). Coronoid reconstruction with autologous iliac crest bone graft in chronic elbow instability through a medial approach. Oper. Orthopade Traumatol., 34 (6). S. 419 - 431. MUNICH: URBAN & VOGEL. ISSN 1439-0981

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Abstract

Objective Neutralizing a posteromedial rotatory instability (PMRI) caused by coronoid deficiency by restoration of the humeroulnar joint surface with an autologous iliac crest bone graft. Indications Surgery is indicated in patients with chronic deficiency of the anteromedial facet of the coronoid with subsequent PMRI. Contraindications Coronoid reconstruction is not recommended in patients with advanced osteoarthritis of the elbow caused by subluxation of the humeroulnar joint. General contraindications like acute infection, pregnancy and lack of operability should also be taken into account. Surgical technique First, a medial approach is established and the base of the coronoid is prepared. Afterwards an autologous iliac crest bone graft is placed onto the defect and secured by screws or a plate. In addition, a reconstruction of the anterior bundle of the medial collateral ligament with an autologous tendon graft is performed. Postoperative management An elbow orthesis is worn for 6 weeks after surgery to avoid valgus or varus stress. There is no restriction in range of motion. A continuous passive motion elbow chair supports the patient in regaining elbow mobility. Results Between 2015 and 2017, we treated 10 patients suffering from chronic coronoid defects with coronoid reconstruction. Eight of the patients were available for follow-up 86 weeks after surgery. The mean age was 41.4 years. In all patients, elbow range of motion and patient-related outcome measures were improved after surgery. Plain radiographs illustrated correct centering of the elbow joint. One patient had to undergo elbow arthroplasty and was excluded. Coronoid reconstruction with an autologous iliac crest bone graft restored humeroulnar joint congruency and improved satisfaction in patients suffering from chronic coronoid deficiency.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schneider, M. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmermann, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hollinger, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmerer, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burkhart, K. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-673956
DOI:	10.1007/s00064-022-00783-6
Journal or Publication Title:	Oper. Orthopade Traumatol.
Volume:	34
Number:	6
Page Range:	S. 419 - 431
Date:	2022
Publisher:	URBAN & VOGEL
Place of Publication:	MUNICH
ISSN:	1439-0981
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTEROLATERAL ROTATORY INSTABILITY; RADIAL HEAD; COLLATERAL LIGAMENT; FRACTURE-DISLOCATION; ANTEROMEDIAL FACET; STABILITY; REPLACEMENT; KINEMATICS; INJURY Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67395