Proximale Humerusfrakturen - was sollen wir tun?

Zusammenfassung

Eine Therapieempfehlung zur Behandlung der proximalen Humerusfraktur nach den Kriterien der evidenzbasierten Medizin gibt es trotz der Häufigkeit der Verletzung noch nicht. Wie bei vielen anderen Verletzungen fehlt es an prospektiv randomisierten Vergleichsstudien. Obwohl die konservative Therapie nach wie vor ein fester Bestandteil der Behandlung dieser Verletzung bleibt, werden operative Stabilisierungen zunehmend häufiger durchgeführt. Aktuell kommen hierzu verschiedene Verfahren zum Einsatz, wobei die Plattenosteosynthese in verschiedenen Studien als gutes Implantat beschrieben wird. In dieser Arbeit wird ein Überblick über die Besonderheiten der proximalen Humerusfraktur und deren Behandlung gegeben.

Abstract

Fracture of the proximal humerus, representing 5 % of all extremity fractures, is a common fracture in everyday clinical life. Apart from the distal fracture of the radius and fractures adjacent to the hip joint, the proximal humerus fracture is the most common fracture in elderly people. From the point of view of evidence-based medicine it is still not possible to define the “gold standard” for stabilisation of fractures of the humeral head. Operative stabilisation of fractures of the humeral head is still a surgical challenge and remains the subject of many clinical and experimental investigations. New findings about the biomechanics and pathophysiology of bones and soft tissue have, in recent years, influenced and pointed the way in the design and function of new forms of osteosynthesis. In particular, the development of locking implants has strongly influenced modern surgical techniques. The aim of this manuscript was to describe the special features of the proximal humerus fracture and its treatment.

Schlüsselwörter

proximaler Humerus - Humeruskopffraktur - winkelstabile Platte - PHILOS - Schulter

Key words

proximal humerus fracture - shoulder - new implants - locking plates - humerus

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