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Primäre Frakturprothese und inverse Schulterprothese bei komplexer Humeruskopffraktur

Eine Alternative zur gelenkerhaltenden Osteosynthese?

Primary fracture protheses and reverse shoulder arthroplasty in complex humeral head fractures

An alternative to joint-preserving osteosynthesis?



In den letzten Jahren hat sich bei der operativen Versorgung komplexer Humeruskopffrakturen ein dynamischer Wandel vollzogen. So hat der primäre Einsatz von inversen Schulterfrakturprothesen bei älteren Patienten erheblich an Bedeutung gewonnen. Die kurz- bis mittelfristigen Ergebnisse der inversen Frakturprothetik präsentieren sich vielversprechend, Langzeitergebnisse stehen jedoch noch aus. Hingegen hat die anatomische Frakturprothetik zugunsten der Osteosynthese und inversen Frakturprothese stark an Stellenwert verloren.


Dieser Übersichtsartikel beschäftigt sich mit der Frage, ob und wann eine primäre Frakturprothese zur Behandlung der komplexen Humeruskopffraktur eine Alternative zur gelenkerhaltenden Osteosynthese darstellt bzw. dieser sogar vorzuziehen ist. Des Weiteren soll auf das jeweilige Indikationsspektrum der anatomischen und inversen Frakturprothetik eingegangen werden.



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.

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Arbeitsgemeinschaft für Osteosynthesefragen


American Shoulder and Elbow Surgeons Score


Chronisches regionales Schmerzsyndrom


Disabilities of the Arm, Shoulder, Hand Score


Anatomische Frakturhemiprothese


„Level of evidence“


Multivariater Regressionsanalyse


Oxford Shoulder Score


Orthopedic Trauma Association




Inverse Frakturprothese


University of California Los Angeles Score


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Correspondence to B. Erdle.

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B. Erdle, K. Izadpanah, H. Eberbach, J. Zwingmann, M. Jaeger, N. Südkamp und D. Maier geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Erdle, B., Izadpanah, K., Eberbach, H. et al. Primäre Frakturprothese und inverse Schulterprothese bei komplexer Humeruskopffraktur. Orthopäde 47, 410–419 (2018).

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  • Ältere
  • Frakturfixierung, interne
  • Hemiprothese
  • Proximale Humerusfraktur
  • Schulterprothese


  • Elderly
  • Fracture fixation, internal
  • Hemiarthroplasty
  • Humeral fractures, proximal
  • Prosthetic Shoulder