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Online ISSN 1827-1707
TRAUMA AND EMERGENCY SURGERY
Marquass B., Josten C.
Department of Trauma and Reconstructive Surgery, University Hospital, Leipzig, Leipzig, Germany
Elbow fractures and dislocations are common injuries that might result in a functional loss of the upper extremity. Successful treatment of elbow instability is aided by a biomechanical understanding of the pathoanatomy. Conservative therapy of simple elbow dislocation usually leads to satisfactory results. In addition to ligamentous injuries, fractures can also contribute to elbow instability. The treatment algorithm for fractures of the radial head takes additional ligament injuries into account and demands an individual approach between reconstruction, resection and arthroplasty. The treatment of distal humeral fractures has other specificity. Here complex anatomy and in elder patients a low bone density can make the treatment of those fractures to a challenge. Recent developments include anatomic preshaped angle stable plates. First results are encouraging and one can expect for the future lower loosening rates. Comparable to the distal humerus, a anatomic preshaped plate is also available for the olecranon. Beside good reduction and fixation, in this fracture it is important not to overlook a hidden Monteggia-injury. The combination of bony and ligamentous injuries makes the treatment of elbow injuries challenging. Thus, bony and ligamentous injuries have to be addressed or keep in mind when indications are discussed.