Stedtfeld Hans-Werner, Mittlmeier Thomas
Department of Trauma, Klinikum Nürnberg Klinikum Süd, Nürnberg, Germany.
Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany.
Eur J Trauma Emerg Surg. 2007 Aug;33(4):367-74. doi: 10.1007/s00068-007-7094-5. Epub 2007 Jul 31.
Antegrade interlocking nailing has been established as a valid option of treatment in proximal humeral fractures which follows the principles of minimum invasive surgery. The introduction of angular stability into intramedullary nailing has increased the stability of reconstruction even in osteoporotic fractures. The outcome of the surgical procedure essentially depends on the adequate intraoperative management of the specific features and challenges of the corresponding fracture type. The creation of the correct nail entry point is crucial for anatomic reduction and stability of the reconstruction, as well. The knowledge on intraoperative reduction aids and additional tools of enhancing the stability of the reconstruction alleviates a mechanically sound application of antegrade intramedullary nailing in most highly unstable proximal humeral fractures.
顺行交锁髓内钉固定术已成为遵循微创手术原则治疗肱骨近端骨折的一种有效选择。髓内钉固定术中引入角稳定性，即使在骨质疏松性骨折中也提高了重建的稳定性。手术结果主要取决于对相应骨折类型的特定特征和挑战进行充分的术中处理。正确确定髓内钉进针点对于解剖复位和重建的稳定性也至关重要。了解术中复位辅助工具和增强重建稳定性的其他工具，有助于在大多数极不稳定的肱骨近端骨折中合理应用顺行髓内钉固定术。
