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Arthritis und Rheuma 2015; 35(02): 100-103
DOI: 10.1055/s-0037-1618357
Endoprothetik kleinerer Gelenke
Schattauer GmbH

Handgelenkendoprothese versus Arthrodese

Wrist arthroplasty versus arthrodesis
A. Wanivenhaus
1   Wien, Österreich
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
27. Dezember 2017 (online)

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Zusammenfassung

Die Destruktion des Handgelenkes stellt eine wesentliche Störung der Gelenkkette der oberen Extremität dar. Kraft- und Funktionsverlust sind neben Schmerz die Indikation zum operativen Vorgehen. Die klassische Versteifungsoperation des Handgelenkes erhält zunehmend Konkurrenz durch die Gelenkfunktion-erhaltende Endoprothese. Zweitere weist gute früh- bis mittelfristige Resultate auf, im Langzeitverlauf jedoch hohe Revisionsraten wegen Lockerung meist des karpalen Teils, verbunden mit Polyethylenabrieb – langfristig ist eine Konversion in eine Arthrodese erforderlich. Der Goldstandard am Handgelenk bleibt die Arthrodese; die Endoprothese stellt eine Individuallösung dar. Es liegt in der Verantwortung des Opera-teurs, zwischen Mobilität und Durabilität zu wählen.

Summary

The destruction of the wrist represents a substantial disorder of the upper extremity. Reduced strength and loss of function are the indications for the operational approach in addition to pain. The classical fusion surgery of the wrist is receiving increasing competition from the function-preserving joint endoprosthesis. The endoprosthesis has good short and mid-term results. During long-term high revision rates due to easing usually of the carpal part combined with polyethylene wear and in the long term, a conversion to an arthrodesis is required. The gold standard of the wrist treatment remains the arthrodesis; the endoprosthesis represents an individual solution. It is up to the responsibility of the surgeon to select between mobility and durability.

Schlüsselwörter

Handgelenkdestruktion - Handgelenkarthrodese - Handgelenkendoprothese - Handgelenk -instabilität

Keywords

Osteoarthritis wrist - rheumatoid arthritis wrist - wrist arthroplasty - wrist arthrodesis - wrist instability
 

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