Das chronisch dezentrierte Ellenbogengelenk View Full Text


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Article Info

DATE

2016-12

AUTHORS

Jan Geßmann, Matthias Königshausen, Alexander von Glinski, Valentin Rausch, Thomas A. Schildhauer, Dominik Seybold

ABSTRACT

Eine chronische Dezentrierung des Ellenbogengelenks ist selten und beruht meist auf einem Substanzdefekt der knöchernen Stabilisatoren, wobei ein Koronoiddefekt die häufigste Ursache darstellt. Bewegungseinschränkung und Schmerz sind die Folge der Gelenkdislokation, von Knorpelschäden, Kontrakturen und Vernarbungen. Primäres Behandlungsziel stellt die Rezentrierung des Gelenks mit Wiedererlangen eines funktionellen Bewegungsausmaßes dar. Die gelenkrekonstruktiven Verfahren sind aufwendig und werden z. T. kontrovers diskutiert. Das grundlegende Behandlungsprinzip beruht auf der stabilen Rekonstruktion des humeroulnaren Gelenks. Im Behandlungsalgorithmus erfolgt zunächst die Rekonstruktion der knöchernen Stabilisatoren über einen Koronoidaufbau und/oder eine Radiuskopfprothese. Im Anschluss müssen Insuffizienzen weichteiliger Stabilisatoren beurteilt und adressiert werden. Ein Bewegungsfixateur dient dem Schutz der Rekonstruktion und ermöglicht eine unmittelbar postoperative Mobilisation des Ellenbogengelenks. Als negative Prognosefaktoren sind eine verzögerte Gelenkrekonstruktion, eine persistierende Gelenkinstabilität und ein Arthrosenachweis definiert worden. More... »

PAGES

218-227

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  • Journal

    TITLE

    Obere Extremität

    ISSUE

    4

    VOLUME

    11

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11678-016-0379-8

    DOI

    http://dx.doi.org/10.1007/s11678-016-0379-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1013114054


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