Cuny Christian
, 26, rue du Coëtlosquet, 57000, Metz, France.
Eur J Orthop Surg Traumatol. 2017 Apr;27(3):279-284. doi: 10.1007/s00590-017-1928-6. Epub 2017 Mar 4.
Proximal humerus fractures are characterized by their frequency, the difficulties and the absence of treatment of reference. New means of osteosynthesis appeared since the years 2000, as well as the preferential recourse to the reversed prostheses of shoulder. A chapter is dedicated to classifications, as a whole not very reproducible. The new treatments are represented by the nails, such as Telegraph, and the plates with blocked screws. It appeared a real progress in the osteosyntheses and became infinitely more solid with the stability of the screws in the bone. The advantage of the reversed prostheses of shoulder where the stability of the tuberosities is not essential any more to the good performance from now on is recognized. They are allowed like treatment of reference for the complex fractures of the elderly people. Classifications remain of delicate use. They are known to be not very reproducible. Classification of AST, with quantification of displacement, is proposed. Various reflections relate to the rotators cuff and cephalic necrosis.
肱骨近端骨折的特点是其发生频率、治疗难度以及缺乏标准治疗方法。自21世纪初以来,出现了新的骨固定方法,以及更倾向于使用反置式肩关节假体。有一章专门讨论分类,总体而言分类的可重复性不太好。新的治疗方法包括髓内钉,如Telegraph髓内钉,以及带锁定螺钉的钢板。骨固定技术取得了切实进展,并且由于螺钉在骨内的稳定性,固定变得更加牢固。现在已经认识到反置式肩关节假体的优势,即结节的稳定性对于良好的功能不再至关重要。它们被认可为老年人复杂骨折的标准治疗方法。分类的使用仍然很微妙。已知其可重复性不太好。提出了AST分类法,并对移位进行量化。各种思考涉及肩袖和头坏死。