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Die komplexe proximale Humerusfraktur

Frakturmorphologie und Konsequenzen für die tägliche Praxis

Complex proximal humeral fractures

Pathomorphology and implications for daily practice

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Zusammenfassung

Die Frakturmorphologie ist der wegweisende Faktor in der Behandlung der komplexen proximalen Humerusfraktur. Kombinationen aus unterschiedlich einwirkender Kraft zum Zeitpunkt des Unfalls, regional ungleicher Knochenqualität und Quantität sowie verschiedener Vektoren der schulterumgreifenden Muskulatur führen zu einer hohen Variabilität. Es existieren mehrere charakteristische Merkmale, die eine Aussage zu Stabilität, Heilungswahrscheinlichkeit und Prognose der Fraktur zulassen. Für den behandelnden Arzt ergibt sich die Chance, durch ein gutes Verständnis der Frakturmorphologie die Therapieentscheidung zu fundieren und die eigenen Ergebnisse positiv zu beeinflussen.

Abstract

Fracture morphology guides assessment and decision making in the treatment of proximal humeral fractures. The mechanism of injury, regional variances in bone quality and quantity as well as the distinctive force transaction of the rotator cuff contribute to the high variability of proximal humeral fractures. Certain characteristics can be used to predict stability, probability of healing and the prognosis of proximal humeral fractures. As a consequence, a profound understanding of the fracture morphology enables knowledge-based decision making and improves treatment results.

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Danksagung

Der Autor dankt Herrn Prof. Dr. Stefan Milz, Anatomische Anstalt der Ludwig-Maximilians-Universität München und Herrn Prof. Dr. Ernst Wiedemann, OCM Klinik München, für ihre Beratung im Rahmen dieses Beitrags.

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  1. Sektion Schulter- und Ellenbogenchirurgie, Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Ludwig-Maximilians-Universität, Nussbaumstr. 20, 80336, München, Deutschland

    Ben Ockert

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Correspondence to Ben Ockert.

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

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Ockert, B. Die komplexe proximale Humerusfraktur. Obere Extremität 14, 83–92 (2019). https://doi.org/10.1007/s11678-019-0510-8

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