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OP-Journal 2013; 29(1): 32-38
DOI: 10.1055/s-0032-1328483
Georg Thieme Verlag KG Stuttgart · New York

Die konservative Behandlung der proximalen Oberarmfraktur[*]

Christian Krettek
,
Nael Hawi
,
Ulrich Wiebking
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Publication History

Publication Date:
23 May 2013 (online)

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Zusammenfassung

Die proximale Humerusfraktur ist eine der häufigsten Frakturen des Menschen. Etwa 80 % der Frakturen sind wenig oder nicht disloziert und damit der konservativen Therapie gut zugänglich, etwa 80 % der Patienten sind über 60 Jahre alt. Winkelstabile Platte und Verriegelungsnagel haben bei hohen Komplikations- und Revisionsraten die Erwartungen vor allem beim älteren Patienten mit Osteoporose nicht erfüllen können. Prospektiv randomisierte Studien aus Finnland und Schweden haben ergeben, dass beim älteren Patienten über 60 Jahre bei der dislozierten 4-Teile-Fraktur die Ergebnisse der Plattenosteosynthese oder der Frakturprothese nicht besser sind als die der konservativen Behandlung. Gleiches gilt auch für die Frakturprothese.

Conservative Treatment of Proximal Humerus Fractures

Proximal humerus fractures are among the most common fractures. About 80 % of all proximal humerus fractures are undisplaced or minimally displaced and suitable for non-operative treatment. About 80 % of all patients are more than 60 years old. Locked plating and interlocking nailing have not fulfilled the expectations, especially in elderly patients with osteoporotic bone. Prospective randomised studies from Scandinavia have shown that in elderly patients above 60 years of age clinical results and outcome in cases with dislocated three- and four-part fractures treated with locked plates or hemiarthroplasty are not better than those for patients treated non-operatively.

* Die Publikation enthält Auszüge aus Krettek C, Wiebking U. Proximale Humerusfraktur: Ist die winkelstabile Plattenosteosynthese der konservativen Behandlung überlegen? Unfallchirurg 2011; 114: 1059–1067 (mit freundlicher Genehmigung des Springer Verlags, Heidelberg).


 

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