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Z Orthop Unfall 2011; 149(1): 95-110
DOI: 10.1055/s-0030-1270744
Refresher Orthopädie und Unfallchirurgie
Rubrikherausgeber: R. Hoffmann, Frankfurt, R. Windhager, Graz
© Georg Thieme Verlag KG Stuttgart · New York

Frakturen des distalen Humerus

Distal Humeri FracturesK. Schmidt-Horlohé1 , S. Siebenlist2 , U. Stöckle2 , R. Hoffmann1
  • 1Abteilung für Unfallchirurgie und orthopädische Chirurgie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt am Main
  • 2Klinikum rechts der Isar, Abteilung für Unfallchirurgie, TU München, München
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Publication History

Publication Date:
16 February 2011 (online)

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Zusammenfassung

Frakturen des distalen Humerus stellen mit ca. 2–3 % eine seltenere Fraktur dar. Aufgrund der komplexen Gelenkgeometrie und Frakturmuster gilt die distale Humerusfraktur hinsichtlich Diagnostik, Therapie und Nachbehandlung als eine Herausforderung für den behandelnden Arzt. Neben extraartikulären und partiell artikulären Frakturen finden sich zunehmend intraartikuläre Frakturformen. Durch die demografische Entwicklung ist in Zukunft mit einer Zunahme der im Senium typischen, mehrfragmentären artikulären Frakturen bei begleitend schlechter Knochenqualität zu rechnen. Die konservative Therapie durch Immobilisation führt regelhaft zu erheblichen posttraumatischen Bewegungseinschränkungen. Das Ziel einer stabilen und schmerzfreien Gelenkfunktion ist nur durch offene Reposition und unmittelbare übungsstabile Osteosynthese zu erreichen. Zur differenzierten Therapie dieser komplexen Gelenkfrakturen sind detaillierte Kenntnisse der Anatomie und Biomechanik, der operativen Zugangswege und verfügbaren Implantate als auch des Nachbehandlungsregimes erforderlich.

Abstract

Fractures of the distal humerus are rare and count only for a small number of all fractures in mature patients. Due to demographic changes surgeons will be faced with an increasing number of complex multifragmentary fractures with diminished bone quality. As conservative treatment frequently leads to limited and painful elbow function, open reduction and stable internal fixation with early range of motion exercises are considered the gold standard. Detailed knowledge of the complex articular anatomy, the biomechanics, operative approaches and available implants is needed for the proper management of these complex fractures.

Key words

distaler Humerus - Fraktur - operative Zugänge - Osteosynthese - Winkelstabilität

Key words

distal humerus - fracture - surgical exposures - osteosynthesis - angular stability

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Dr. med. Kay H. Schmidt-Horlohé

Berufsgenossenschaftliche Unfallklinik Frankfurt am Main
Abteilung für Unfallchirurgie und orthopädische Chirurgie

Friedberger Landstraße 430

60389 Frankfurt/Main

Phone: 069/4 75 28 41, 069/4 75 22 23

Email: kay.schmidt-horlohe@bgu-frankfurt.de

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