Braunstein V
Orthopädie und Unfallchirurgie, Sports Clinic München, Ottobrunnerstraße 55, Munich, Germany.
Unfallchirurg. 2013 Aug;116(8):680-3. doi: 10.1007/s00113-013-2408-z.
The majority of proximal humerus fractures are treated conservatively resulting in satisfying results. Fractures which need to be treated operatively are challenging for the therapist, postoperative treatment and the patient. It is inadequate to establish a therapy concept only by using radiological images and the resulting classification. Factors which take the patient, the injury and the surgeon into consideration have to be included in the decision-making process. Operative reconstruction results in a high rate of complications. This could be the reason why even complex fractures are treated conservatively by some therapists, especially in older patients. Locking plates are used increasingly. Specific complications, such as primary or secondary screw perforation result in a high rate of revision surgery.
大多数肱骨近端骨折采用保守治疗,效果令人满意。需要手术治疗的骨折对治疗师、术后治疗及患者来说都具有挑战性。仅通过放射影像及由此得出的分类来制定治疗方案是不够的。决策过程必须考虑到患者、损伤情况及外科医生等因素。手术重建会导致较高的并发症发生率。这可能就是为什么一些治疗师,尤其是对老年患者,即使是复杂骨折也采用保守治疗的原因。锁定钢板的使用越来越多。特定的并发症,如原发性或继发性螺钉穿孔,导致翻修手术的发生率较高。