الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
The elbow is a complex articulation higly affecting the upper limb function. It is contoured to permit motion in flexion, extension, supination and pronation.
Arthroplasty, in general, is an operation to restore motion to a joint and function to the muscles, ligaments, and soft tissue structures that control the joint. Understanding of mechanical principles in relation to functional anatomy and appreciation of elegant interrelations of form and function are necessary for undertaking repair and reconstruction of the elbow. In recent years the design of prosthetic implants has been improved because of better understanding of axis of motion, stabilizing factors, load distribution and forces about the elbow joint. Also these factors can explain the causes of biomechanical complications like instability, dislocation and fracture of the component.
Proper patient selection is very important. Age of the patient, activity and the underlying pathology should be considered.
Replacement arthroplasty is indicated in painful stiff joints. In rheumatoid arthritis, as there is intractable pain together with radiological evidence of destruction of the radio-humeral and humero-ulnar joints total elbow replacement is indicated.Primary osteo-arthritis of the elbow ,although being rare,is another indication for elbow arthroplasty. Also post-traumatic damage of the articular surfaces either recent (mainly in old patients),or old complicated by ankylosis or non-union is difficult to treat without
implant replacement. Indications of semi constrained and unconstrained
prostheses are the same but semi constrained device is more suitable in patients with instability and gross bone loss and resurfacing (unconstrained) device is suitable for young individuals with rheumatoid arthritis.