Supra- und diakondyläre Frakturen des distalen Humerus

Zusammenfassung

Frakturen des distalen Humerus im Erwachsenenalter stellen eine seltene Verletzung dar. Die konservative Therapie durch Immobilisation führt fast immer zu erheblichen posttraumatischen Bewegungseinschränkungen. Das Ziel einer dauerhaft stabilen und schmerzfreien Gelenkfunktion ist in der Regel nur durch eine offene Reposition und übungsstabile Osteosynthese zu erreichen. Die operative Therapie wird durch eine komplexe Gelenkgeometrie, multifragmentäre Frakturformen und die oftmals schlechte Knochenqualität der im höheren Lebensalter zunehmend vorkommenden Fraktur erschwert. Um optimale Behandlungsergebnisse zu erzielen, sind detaillierte Kenntnisse der Anatomie und Biomechanik, der Zugangswege und geeigneten Implantate als auch der operativen Strategie erforderlich.

Abstract

Fractures of the distal humerus count for only a small number of all fractures in mature patients. As conservative treatment is frequently associated with a limited and painful elbow function, open reduction and stable internal fixation with early range of motion exercises are established as the gold standard. However, multifragmentary fractures with diminished bone quality in the growing elderly population represent a challenge for surgical treatment. Detailed knowledge of the complex articular anatomy, the biomechanics, operative approaches and available implants as well as an injury-specific treatment algorithm are needed for the successful management of these complex fractures.

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