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Das präformierte LCP®-Plattenfixateursystem bei distalen Humerusfrakturen AO-Typ 13C3

Klinische Erfahrungen und Behandlungsergebnisse unter Berücksichtigung des Zugangsweges

Preformed plate-fixation system for type AO 13C3 distal humerus fractures

Clinical experiences and treatment results taking access into account

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Zusammenfassung

Die übungsstabile osteosynthetische Versorgung von intraartikulären distalen Humerusfrakturen ist Voraussetzung für eine rasche Beübung des Ellenbogengelenks. Die Doppelplattenosteosynthese hat sich hierbei als effizientes Osteosyntheseverfahren etabliert, wobei die Positionierung der Platten am radialen und ulnaren Pfeiler mitunter noch kontrovers diskutiert wird. Die winkelstabile Verbindung von Platten und Schrauben zeigt hierbei biomechanische Vorteile hinsichtlich der Primärstabilität, insbesondere bei mehrfragmentären Gelenkfrakturen (AO-Typ 13C3) und bei älteren Patienten mit osteopener Knochenqualität. Der dorsale Zugangsweg mit Olecranonosteotomie bietet bei C3-Frakturen des distalen Humerus im Gegensatz zu anderen Zugängen dem Operateur eine umfassende Panoramasicht auf das zerstörte Gelenkmassiv.

Eine neue Entwicklung sind anatomisch präformierte Plattenfixateursysteme wie das LCP®-System für den distalen Humerus (Fa. Synthes®). Im vorliegenden Beitrag werden Behandlungsergebnisse mit diesem System bei der Osteosynthese von distalen Humerusfrakturen vom AO-Typ 13C3 anhand von 11 Fällen kritisch analysiert.

Abstract

In distal intraarticular humerus fractures primary stable osteosynthesis is essential for early mobilization of the elbow joint. Double-plate osteosynthesis techniques using different configurations are the gold standard. In the literature plate position is sometimes discussed controversially. In cases of distal humerus fractures (type AO 13C3) with metaphyseal comminution, as well as in elderly patients with poor bone quality, utilizing locking plates with angular stability was found to have increased structural properties with regard to primary fixation stability. The dorsal approach with osteotomy of the olecranon seems to be very effective in open reduction and internal fixation of this type of fracture.

One new development is the anatomically preformed plate-fixation systems such as the LCP®-System for distal humerus (Synthes®). This study presents our first experience with this system in 11 cases of open reduction and internal fixation of type AO 13C3 distal humerus fractures. The system-specific features and intraoperative options were analyzed.

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Authors and Affiliations

  1. Klinik und Poliklinik für Unfall-, Hand- & Wiederherstellungschirurgie, Universitätsklinikum, Waldeyerstraße 1, 48149, Münster, Deutschland

    A. Rübberdt, C. Surke, T. Fuchs, U. Frerichmann & M.-J. Raschke

  2. Institut für Klinische Radiologie, Universitätsklinikum, Münster, Deutschland

    L. Matuszewski & V. Vieth

Authors
  1. A. Rübberdt
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  2. C. Surke
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  3. T. Fuchs
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  4. U. Frerichmann
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  5. L. Matuszewski
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  6. V. Vieth
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  7. M.-J. Raschke
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Correspondence to A. Rübberdt.

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Rübberdt, A., Surke, C., Fuchs, T. et al. Das präformierte LCP®-Plattenfixateursystem bei distalen Humerusfrakturen AO-Typ 13C3. Unfallchirurg 111, 308–322 (2008). https://doi.org/10.1007/s00113-008-1434-8

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  • DOI: https://doi.org/10.1007/s00113-008-1434-8

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