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Z Orthop Unfall 2010; 148(3): 353-362
DOI: 10.1055/s-0030-1249919
Refresher Orthopädie und Unfallchirurgie
Rubrikherausgeber: R. Hoffmann, Frankfurt R. Windhager, Graz
© Georg Thieme Verlag KG Stuttgart · New York

Proximale Humerusfraktur

H. Lill1 , C. Voigt1
  • 1Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH Hannover
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Publication History

Publication Date:
24 June 2010 (online)

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Zusammenfassung

Die proximale Humerusfraktur gehört zu den typischen Altersfrakturen mit zunehmender Inzidenz. Es resultieren komplexe Frakturmuster. Röntgenaufnahmen in 2 Ebenen stellen die Basisdiagnostik dar. Häufig ist eine weiterführende CT-Diagnostik zur Erfassung des gesamten Frakturausmaßes notwendig. Die Dislokationsgrenzen für die operative Therapie werden zunehmend enger gesteckt. Vorteile der operativen Therapie sind die Möglichkeit zur frühfunktionellen Nachbehandlung und die schnelle Reintegration in den Alltag. Winkelstabile Nagel- und Plattenosteosynthese als konkurrierende Verfahren werden favorisiert. Tendenziell wird die Plattenosteosynthese bei höhergradigen Frakturen bevorzugt. Nicht rekonstruierbare Frakturen indizieren die Implantation einer primären Frakturprothese, zunehmend empfohlen in Form einer inversen Prothese beim über 75-jährigen Patienten.

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Prof. Dr. med. Helmut Lill
PD Dr. med. Christine Voigt

Klinik für Unfall- und Wiederherstellungschirurgie
Diakoniekrankenhaus Friederikenstift gGmbH Hannover

Humboldtstraße 5

30169 Hannover

Email: helmut.lill@ddh-gruppe.de