Erdle B, Izadpanah K, Eberbach H, Zwingmann J, Jaeger M, Südkamp N, Maier D
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
Orthopade. 2018 May;47(5):410-419. doi: 10.1007/s00132-018-3570-3.
The surgical management of complex humeral head fractures has adapted dynamically over the course of the last decade. The primary use of reverse shoulder arthroplasty in elderly patients has gained in relevance due to promising short and middle-term results. Long-term results, however, are still pending. The appliance of anatomical hemiarthroplasty, on the other hand, has lost in significance in favour of osteosynthesis and reverse shoulder arthroplasty.
This review article follows the question as to under which circumstances primary fracture arthroplasty reflects an alternative or even a preference to joint-preserving osteosynthesis in the treatment of complex proximal humeral fractures. It also specifies spectrums of indications for anatomical hemiarthroplasty and reverse shoulder arthroplasty.
在过去十年中,复杂肱骨头骨折的手术治疗方法不断动态演变。由于短期和中期效果良好,老年患者中初次使用反肩关节置换术的相关性有所增加。然而,长期效果仍有待观察。另一方面,解剖型半关节置换术的应用在很大程度上已被骨固定术和反肩关节置换术所取代。
本文探讨了在治疗复杂肱骨近端骨折时,在何种情况下初次骨折关节置换术可作为保留关节的骨固定术的替代选择甚至首选。本文还明确了解剖型半关节置换术和反肩关节置换术的适应症范围。