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[创伤后肱骨头坏死——人工关节置换术或关节保留术]

[Post-traumatic necrosis of the humeral head-Endoprosthesis or joint preservation].

作者信息

Wegner A, Wassenaar D, Busch A, Stanjek M, Mayer C, Jäger M

机构信息

Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland.

Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Klinikum Wolfsburg, Sauerbruchstr. 7, 38440, Wolfsburg, Deutschland.

出版信息

Orthopadie (Heidelb). 2022 Oct;51(10):822-828. doi: 10.1007/s00132-022-04307-9. Epub 2022 Sep 9.

Abstract

BACKGROUND

Humerus fractures play a major role in daily clinical routine, and subsequent osteonecrosis is common after osteosyntheses.

OBJECTIVES

The current paper highlights the incidence and cause of osteonecrosis after proximal humerus fractures, with respect to presentation of anatomy and risk factors.

METHODS

Display of the literature and therapy options for humerus fracture and subsequent necrosis.

RESULTS

Humerus fractures are the seventh most frequent fractures in humans. The complication rate is 40%, and the described rate of necrosis is up to 34%. Accordingly, the surgical revision rate is at 19% according to recent literature.

CONCLUSION

The treatment of humerus head fracture must consider numerous variables. The individual type of fracture and the current individual situation of the patient must be included in the process of choosing the right treatment. Modern implants with screw locking features should be used, and for certain circumstances the direct implantation of a prosthesis should be considered. Thereby the expectations of the patient with respect to the postoperative activity level play a major role.

摘要

背景

肱骨骨折在日常临床诊疗中较为常见,骨折内固定术后骨坏死也较为普遍。

目的

本文着重探讨肱骨近端骨折后骨坏死的发生率及病因,涉及解剖结构和危险因素。

方法

展示肱骨骨折及后续坏死的文献及治疗方案。

结果

肱骨骨折是人类第七常见骨折。并发症发生率为40%,报道的坏死率高达34%。根据近期文献,手术翻修率为19%。

结论

肱骨头骨折的治疗必须考虑诸多变量。选择正确治疗方案时应纳入骨折的个体类型及患者当前的个体情况。应使用具有锁定螺钉功能的现代植入物,在某些情况下应考虑直接植入假体。患者对术后活动水平的期望起着重要作用。

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