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[老年与青年——肱骨近端骨折治疗的差异?]

[Old and young-Differences in the treatment of proximal humeral fractures?].

作者信息

Riesselmann Jan N, Reeh Freya M, Lill Helmut, Ellwein Alexander

机构信息

Klinik für Orthopädie und Unfallchirurgie, DIAKOVERE Friederikenstift Hannover, Humboldtstraße 5, 30169, Hannover, Deutschland.

Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2025 May 20. doi: 10.1007/s00113-025-01587-6.

Abstract

The rising incidence of proximal humeral fractures has made this an important topic in the treatment reality of trauma surgery. Given the variety of treatment options available, the question arises as to what extent patient age influences the choice of treatment and, consequently, the functional outcome. In our approach the morphological features of the fracture and individual patient characteristics form the foundation for determining whether surgical or conservative treatment should be pursued. Whenever possible, joint-preserving reconstruction should be the goal in younger patients. In older patients, the implantation of reverse shoulder arthroplasty is the treatment of choice. Joint replacement enables early mobilization of older patients, facilitating a swift return to daily life. Looking ahead, a further increase in the fracture incidence and a corresponding rise in the rate of necessary surgical interventions are anticipated.

摘要

肱骨近端骨折发病率的上升使其成为创伤外科治疗现实中的一个重要话题。鉴于现有多种治疗选择,患者年龄在多大程度上影响治疗选择以及由此产生的功能结果这一问题随之而来。在我们的治疗方法中,骨折的形态特征和患者个体特征是决定应采用手术治疗还是保守治疗的基础。只要有可能,保留关节的重建手术应是年轻患者的治疗目标。对于老年患者,反肩关节置换术是首选治疗方法。关节置换术能使老年患者早期活动,有助于迅速恢复日常生活。展望未来,预计骨折发病率将进一步上升,相应的必要手术干预率也会增加。

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