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Primäre Prothetik: Wann und welche?

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Die proximale Humerusfraktur

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Zusammenfassung

„Komplexe Oberarmkopffrakturen“, d. h. Frakturen mit mehr als 3 oder 4 Fragmenten, mit deutlicher Fehlstellung, schlechter Knochenqualität, kleinen Fragmenten sowie ungünstigen biologischen Prognosekriterien, meist bei älteren Patienten, zeigen bei allen Therapieoptionen schlechtere Resultate. Dies gilt sowohl für die konservative (Torrens et al. 2011) als auch für die operativ rekonstruktive Therapie mit verschiedenen Techniken, perkutan minimalinvasiv oder mit winkelstabilen Platten oder Nägeln auch der neuesten Generation (Brunner et al. 1995; Königshausen et al. 2012; Mittlmeier et al. 2003; Resch et al. 1997). Hier besteht die Grenze zum Gelenkersatz mit anatomischer oder inverser Prothese. Allerdings sind auch die Kriterien für ein sog. gutes Ergebnis („subjective outcome measurement“) und die Konsequenzen durch die Operation und die Nachbehandlung aus der Warte des Patienten mit seinen individuellen und altersabhängigen Bedürfnissen und Möglichkeiten zu betrachten und nicht nur die objektiven Messparameter.

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  1. Krankenhaus Agatharied GmbH, Norbert-Kerkel-Platz 1, 83734, Hausham, Deutschland

    Ulrich H. Brunner Prof. Dr. med.d.

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  1. Ulrich H. Brunner Prof. Dr. med.d.
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  1. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Germany

    Helmut Lill

  2. Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Markus Scheibel

  3. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Germany

    Christine Voigt

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Brunner, U.H. (2014). Primäre Prothetik: Wann und welche?. In: Lill, H., Scheibel, M., Voigt, C. (eds) Die proximale Humerusfraktur. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35257-7_7

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