Biber Roland, Grüninger S, Bail H J
Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Nürnberg, Deutschland.
Klinikum Nürnberg Süd, Breslauer Str. 201, 90471, Nürnberg, Deutschland.
Z Gerontol Geriatr. 2017 Jan;50(1):73-85. doi: 10.1007/s00391-016-1166-2. Epub 2017 Jan 9.
Upper extremity fractures in the elderly are very frequent and second only to hip fractures in the group of fragility fractures. Their impact on mobility and functional decline seems to be underestimated especially when they occur in combination with lower extremity fractures. Fractures of the proximal humerus and the distal radius can often be treated conservatively; however, the indications for operative treatment must not be based on fracture morphology alone and due consideration should be given to all concomitant circumstances affecting functional aspects of patients. Operative treatment of proximal humeral fractures may aim either at preserving the humeral head or at prosthetic replacement. There is broad agreement that this decision should depend on the condition of the humeral head fragment (degree of damage, perfusion). Fixation of distal radial fractures is commonly performed with angular volar stable plates. The more complex the fracture, the more likely conservative treatment will fail.
老年人上肢骨折非常常见，在脆性骨折组中仅次于髋部骨折。它们对活动能力和功能衰退的影响似乎被低估了，尤其是当它们与下肢骨折同时发生时。肱骨近端和桡骨远端骨折通常可以保守治疗；然而，手术治疗的指征不能仅基于骨折形态，还应充分考虑影响患者功能方面的所有伴随情况。肱骨近端骨折的手术治疗可以旨在保留肱骨头或进行假体置换。人们普遍认为，这一决定应取决于肱骨头碎片的状况（损伤程度、血运情况）。桡骨远端骨折通常用掌侧角度稳定钢板进行固定。骨折越复杂，保守治疗失败的可能性就越大。
