Freislederer Florian, Trefzer Raphael, Radzanowski Stephan, Moro Fabrizio, Scheibel Markus
Schulter- und Ellbogenchirurgie, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz.
Centrum für Muskuloskeletale Chirurgie (CMSC), Charité-Universitätsmedizin Berlin, Berlin, Deutschland.
Unfallchirurgie (Heidelb). 2022 Sep;125(9):681-689. doi: 10.1007/s00113-022-01212-w. Epub 2022 Jul 14.
The aim of this review article is to present the indications for an anatomical fracture prosthesis, mostly as a shoulder hemiprosthesis (SHEP) and its value in comparison to other procedures. The healing of the tuberosities in the anatomical position and an intact rotator cuff are particularly important for the successful implantation of a SHEP after proximal humeral fractures. For older patients (> 70 years), the use of reverse shoulder arthroplasty achieves more reliable results and is associated with a lower revision rate. The indications for implantation of a SHEP in non-reconstructible proximal humeral fractures, usually with a head split, should be carefully considered and can be used in cases with well-preserved large tuberosities and in younger patients. Complications of SHEP, such as secondary rotator cuff insufficiency, tuberosity dislocation or resorption and secondary glenoid wear, can be treated using a conversion or a change to reverse shoulder arthroplasty.
这篇综述文章的目的是介绍解剖型骨折假体的适应证，主要是作为半肩关节假体（SHEP），以及与其他手术方法相比其价值。在肱骨近端骨折后成功植入SHEP时，结节在解剖位置的愈合以及完整的肩袖尤为重要。对于老年患者（>70岁），使用反肩关节置换术可取得更可靠的结果，且翻修率较低。在不可重建的肱骨近端骨折（通常伴有头劈裂）中植入SHEP的适应证应仔细考虑，可用于大结节保存良好的病例以及年轻患者。SHEP的并发症，如继发性肩袖功能不全、结节脱位或吸收以及继发性关节盂磨损，可通过转换或改为反肩关节置换术进行治疗。
