Zusammenfassung
Die proximale Humerusfraktur ist eine typische Fraktur des alten Menschen. Die klinische Klassifikation erfolgt nach wie vor nach Neer. Neben der Vaskularität ist insbesondere die Knochenqualität der Fragmente eine entscheidende Determinate, inwieweit eine Osteosynthese möglich ist. Bei fehlender Vaskularität und/oder schlechter Knochenqualität stellt die Frakturprothese nach wie vor eine relevante Therapieoption dar. In der vorliegenden Arbeit werden die Indikation, die OP-Technik, die Rehabilitation sowie die Ergebnisse der Frakturprothese dargestellt.
Abstract
The proximal humerus fracture is a typical injury of the senile patient. This fratcure is clinically classified according to Neer. Bone quality and vascularity are important factors for the possibility of open reduction and internal fixation. In patients with bad bone quality and/or no bone vascularity early hemireplacement is indicated. In the present paper we present the indication, the surgical technique, the early rehabilitation as well as the results for fracture hemireplacement of the shoulder.
Schlüsselwörter
Proximale Humerusfraktur - Hemiprothese - Indikation - Rehabilitation - Ergebnisse
Key words
Proximal humerus fracture - hemireplacement - indications - rehabilitation - results
Literatur
-
1
Heers G, Torchia M E.
Shoulder hemiarthroplasty for proximal humeral fractures.
Orthopäde.
2001;
30 (6)
386-394
-
2 Jerosch J, Heisel J. Schulterendoprothetik. Darmstadt; Steinkopff-Verlag 2002
-
3
Neer C.
Displaced proximal humeral fractures. I. Classification and Evaluation.
J Bone Joint Surg Am.
1970;
52
1077-1089
-
4
Doyle A J, Burks R T.
Comparison of humeral head retroversion with the humeral axis biceps groove relationship: A study in live subjects and cadavers.
Journal of Shoulder and Elbow Surgery.
1998;
7 (5)
453-457
-
5
Jerosch J, Bödecker S.
Funktionelle Ergebnisse nach Hemiarthroplastik des Schultergelenkes nach proximaler Humerusfraktur in Abhängigkeit von der Positionierung der Prothese.
Orthopädische Praxis.
2003;
39
156-165
-
6 Attmanspacher T, Dittrich V, Stübinger A, Stedtfeld H-W. Mittelfristige Ergebnisse nach Hemialloarthroplastik bei Frakturen des proximalen Humerus. In: 17. Steglitzer Unfalltagung; 18. - 19.9.1998. Berlin; 1998
-
7
Ambacher T, Erli H J, Paar O.
Results after primary hemiarthroplasty of dislocated humeral head fractures.
Zentralblatt für Chirurgie.
2000;
125 (9)
750-755
-
8
Moeckel B H, Dines D M, Warren R F, Altchek D W.
Modular Hemiarthroplasty for Fractures of the Proximal Part of the Humerus.
Journal of Bone and Joint Surgery-American Volume.
1992;
74A (6)
884-889
-
9
Boss A, Hintermann B.
Primary endoprosthesis in comminuted humeral head fractures in elderly patients.
Unfallchirurg.
1997;
100 (11)
867-873
-
10
Schmidt-Wiethoff R, Wolf P, Lehmann M, Habermeyer P.
Physical activity after shoulder arthroplasty.
Sportverletzung-Sportschaden.
2002;
16 (1)
26-30
-
11
Bosch U, Fremerey R W, Skutek M, Lobenhoffer P, Tscherne H.
Hemiarthroplasty - A primary or secondary procedure for three- and four-part proximal humeral fractures in elderly patients?.
Unfallchirurg.
1996;
99 (9)
656-664
-
12
Stoffel K, Fellmann J, Meier G, Bereiter H.
Relevant differences in posttraumatic and degenerative shoulder hemiarthroplasty (a mid-term follow-up).
Zeitschrift für Orthopädie und ihre Grenzgebiete.
2000;
138 (2)
110-117
-
13
Neumann K, Muhr G, Breitfuss H.
Die Endoprothese bei Oberarmkopftrümmerbrüchen. Eine ermutigende Alternative.
Unfallchirurg.
1988;
91 (10)
451-458
-
14
Neumann K, Muhr G, Breitfuss H.
Primärer Kopfersatz der dislozierten Oberarmkopffraktur.
Orthopäde.
1992;
21 (2)
140-147
-
15
Becker R, Pap G, Machner A, Neumann W H.
Strength and motion after hemiarthroplasty in displaced four-fragment fracture of the proximal humerus - 27 patients followed for 1 - 6 years.
Acta Orthopaedica Scandinavica.
2002;
73 (1)
44-49
-
16
Hawkins R J, Bell R H, Jallay B.
Total Shoulder Arthroplasty.
Clinical Orthopaedics and Related Research.
1989;
242
188-194
-
17
Gobel F, Wuthe T, Reichel H.
Ergebnisse der Humeruskopfprothese bei akuten und veralteten Frakturen des proximalen Humerus.
Zeitschrift für Orthopädie und ihre Grenzgebiete.
1999;
137 (1)
25-30
-
18
Jerosch J, Steinbeck J, Langenbrink A.
Ergebnisse nach glenohumeralem alloplastischen Gelenkersatz.
Orthopädische Praxis.
1997;
33
234-239
-
19
Cofield R H.
Total Shoulder Arthroplasty with the Neer Prosthesis.
Journal of Bone and Joint Surgery-American Volume.
1984;
66A (6)
899-906
-
20
Hawkins R J, Switlyk P.
Acute Prosthetic Replacement for Severe Fractures of the Proximal Humerus.
Clinical Orthopaedics and Related Research.
1993;
289
156-160
-
21
Hartsock L A, Estes W J, Murray C A, Friedman R J.
Shoulder hemiarthroplasty for proximal humeral fractures.
Orthopedic Clinics of North America.
1998;
29 (3)
467
-
22
Boyd A, Aliabadi P, Thornhill T S.
Postoperative proximal migrationin total shoulder arthroplasty.
Journal of Arthroplasty.
1991;
6
31-37
-
23
Brostrom L A, Kronberg M, Wallensten R.
Should the Glenoid be Replaced in Shoulder Arthroplasty with an Unconstrained DANA or St-George Prosthesis.
Annales Chirurgiae Et Gynaecologiae.
1992;
81 (1)
54-57
-
24
Laurence M.
Replacement Arthroplasty of the Rotator Cuff Deficient Shoulder.
Journal of Bone and Joint Surgery-British Volume.
1991;
73 (6)
916-919
-
25
Brenner B C, Ferlic D C, Clayton M L, Dennis D A.
Survivorship of Unconstrained Total Shoulder Arthroplasty.
Journal of Bone and Joint Surgery-American Volume.
1989;
71A (9)
1289-1296
-
26
Cofield R H, Edgerton B C.
Total shoulder arthroplasty: complicationsand revision surgery.
Instr Course Lect.
1990;
39
449-462
-
27 Martin S D, Sledge C B, Thomas T S, Thornhill T S. Total shoulder arthroplasty with an unccemented glenoid component. In: American Shoulder and Elbow Surgeons 11th Annual Meeting; 19.2.1995;. Orlando, FL; 1995
-
28
Sperling J W, Cofield R H, Steinman S P.
Shoulder arthroplasty for osteoarthritis secondary to glenoid dysplasia.
Journal of Bone and Joint Surgery-American Volume.
2002;
84A (4)
541-546
-
29
Neer C S, Kirby R M.
Revision of Humeral Head and Total Shoulder Arthroplasties.
Clinical Orthopaedics and Related Research.
1982;
170
189-195
-
30
Wirth M A, Rockwood C A.
Complications of Shoulder Arthroplasty.
Clinical Orthopaedics and Related Research.
1994;
307
47-69
-
31
Torchia M E, Cofield R H.
Long-term results of Neer total shoulder arthroplasty.
Orthop Trans.
1994 - 1995;
18
977
-
32
Cofield R H.
Uncemented Total Shoulder Arthroplasty - a Review.
Clinical Orthopaedics and Related Research.
1994;
307
86-93
-
33 Heras J DL, Cofield R H, Kozak T K, Vlasak R. Instability after shoulder instability. In: 10. Kongress der Europäischen Gesellschaft für Schulter- und Ellenbogenchirurgie; 1997. Salzburg; 1997
-
34
Hersch J C, Dines D M.
Arthroscopy for failed shoulder arthroplasty.
Journal of Arthroplasty.
2000;
16 (6)
606-612
-
35
Barrett W P, Thornhill T S, Thomas W H.
Non-constrained total shoulder arthroplasty for patients with polyarticular rheumatoid arthritis.
Journal of Arthroplasty.
1989;
4
91-96
-
36
Matsen F A, Antoniou J, Rozencwaig R, Campbell B, Smith K L.
Correlates with comfort and function after total shoulder arthroplasty for degenerative joint disease.
Journal of Shoulder and Elbow Surgery.
2000;
9 (6)
465-469
-
37 Rockwood C A, Matsen F A. Global Shoulder Surgical Technique Manual. Warsaw; DePuy 1992
-
38
Boyd A D, Thornhill T S, Barnes C L.
Fractures Adjacent to Humeral Prostheses.
Journal of Bone and Joint Surgery-American Volume.
1992;
74A (10)
1498-1504
-
39
Wright T W, Cofield R H.
Humeral Fractures after Shoulder Arthroplasty.
Journal of Bone and Joint Surgery-American Volume.
1995;
77 (9)
1340-1346
-
40
Bonutti P M, Hawkins R J.
Fracture of the Humeral Shaft Associated with Total Replacement Arthroplasty of the Shoulder - a Case-Report.
Journal of Bone and Joint Surgery-American Volume.
1992;
74A (4)
617-618
-
41
Groh G I, Heckmann M M, Curtis R J, Rockwood C A.
Treatment of fractures adjacent to humeral prothesis.
Orthop Trans.
1994 - 1995;
18
1072
Prof. Dr med. Dr. h. c. Jörg Jerosch
Klinik für Orthopädie und Orthopädischer Chirurgie · Johanna-Etinne Krankenhaus
Am Hasenberg 46
41462 Neuss
Fax: + 49/2131/529-2001
Email: j.jerosch@jek-neuss.de
