Skip to main content

Advertisement

SpringerLink
Log in

Ist die Boileau-Klassifikation für Frakturfolgen des proximalen Humerus noch aktuell?

Is the classification of fracture sequelae of the proximal humerus according to Boileau still up to date?

  • Übersicht
  • Published:
Obere Extremität Aims and scope Submit manuscript

Zusammenfassung

Die erfolgreiche Behandlung von Frakturfolgen am proximalen Humerus stellt im klinischen Alltag weiterhin eine große Herausforderung dar. In der vorliegenden Übersichtsarbeit wird die von Boileau im Jahr 2001 publizierte Klassifikation anhand der verfügbaren Literatur kritisch evaluiert und eine Behandlungsempfehlung für die verschiedenen Pathologien ausgesprochen. Außerdem werden Subklassifikationen für Frakturfolgen Typ 1, Typ 2 und Typ 3 aus der eigenen Arbeitsgruppe vorgestellt, und darauf basierende Therapieempfehlungen präsentiert.

Abstract

The successful treatment of fracture sequelae of the proximal humerus remains a major challenge in clinical practice. In this review, the classification published by Boileau in 2001 is critically evaluated based on the available literature and a treatment recommendation for the different pathologies is given. In addition, subclassifications for fracture sequelae type 1, type 2 and type 3 from our own research group are presented and treatment recommendations based on the suggested subgroups are given.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Antuna SA, Sperling JW, Cofield RH, Rowland CM (2001) Glenoid revision surgery after total shoulder arthroplasty, S 217–224 https://doi.org/10.1067/mse.2001.113961

    Book  Google Scholar 

  2. Badman BL, Mighell M, Kalandiak SP, Prasarn M (2009) Proximal humeral nonunions treated with fixed-angle locked plating and an intramedullary strut allograft. J Orthop Trauma 23:173–179. https://doi.org/10.1097/BOT.0b013e31819b0bdc

    Article  PubMed  Google Scholar 

  3. Boileau P, Chuinard C, Le Huec J (2006) Proximal humerus fracture sequelae, S 121–130 https://doi.org/10.1097/01.blo.0000195679.87258.6e

    Book  Google Scholar 

  4. Boileau P, Trojani C, Walch G et al (2001) Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg 10:299–308. https://doi.org/10.1067/mse.2001.115985

    Article  CAS  PubMed  Google Scholar 

  5. Brunner UH, Scheiberer L (2002) Humeruskopffraktur. Schulterchirurgie. Urban & Fischer, München, S 404–429

    Google Scholar 

  6. Dines DM, Warren RF, Altchek DW, Moeckel B (1993) Posttraumatic changes of the proximal humerus: Malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty. J Shoulder Elb Surg 2:11–21. https://doi.org/10.1016/S1058-2746(09)80132-8

    Article  CAS  Google Scholar 

  7. Duquin TR, Sperling JW, Cofield RH (2013) Unconstrained shoulder arthroplasty for treatment of proximal humeral nonunions. Essent Surg Tech 3:e7. https://doi.org/10.2106/jbjs.st.m.00001

    Article  Google Scholar 

  8. Feeley BT, Fealy S, Dines DM et al (2008) Hemiarthroplasty and total shoulder arthroplasty for avascular necrosis of the humeral head. J Shoulder Elbow Surg 17:689–694. https://doi.org/10.1016/j.jse.2008.03.009

    Article  PubMed  Google Scholar 

  9. Galatz LM, Williams GR, Fenlin JM et al (2004) Outcome of open reduction and internal fixation of surgical neck nonunions of the humerus. J Orthop Trauma 18:63–67. https://doi.org/10.1097/00005131-200402000-00001

    Article  PubMed  Google Scholar 

  10. Kiliç M, Berth A, Blatter G et al (2010) Anatomic and reverse shoulder prostheses in fracture sequelae of the humeral head. Acta Orthop Traumatol Turc 44:417–425. https://doi.org/10.3944/AOTT.2010.2272

    Article  PubMed  Google Scholar 

  11. Mansat P, Guity MR, Bellumore Y, Mansat M (2004) Shoulder arthroplasty for late sequelae of proximal humeral fractures. J Shoulder Elbow Surg 13:305–312. https://doi.org/10.1016/S1058274604000370

    Article  PubMed  Google Scholar 

  12. Martinez AA, Calvo A, Bejarano C et al (2012) The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus. J Orthop Sci 17:141–147. https://doi.org/10.1007/s00776-011-0185-5

    Article  PubMed  Google Scholar 

  13. Matsoukis J, Tabib W, Guiffault P et al (2006) Primary unconstrained shoulder arthroplasty in patients with a fixed anterior glenohumeral dislocation. J Bone Joint Surg Am 88:547–552. https://doi.org/10.2106/JBJS.E.00368

    Article  CAS  PubMed  Google Scholar 

  14. Moineau G, McClelland WB, Trojani C et al (2012) Prognostic factors and limitations of anatomic shoulder arthroplasty for the treatment of posttraumatic cephalic collapse or necrosis (type‑1 proximal humeral fracture sequelae). J Bone Joint Surg Am 94:2186–2194. https://doi.org/10.2106/JBJS.J.00412

    Article  PubMed  Google Scholar 

  15. Pape G, Zeifang F, Bruckner T et al (2010) Humeral surface replacement for the sequelae of fractures of the proximal humerus. J Bone Joint Surg Br 92:1403–1409. https://doi.org/10.1302/0301-620X.92B10.24316

    Article  CAS  PubMed  Google Scholar 

  16. Raiss P, Alami G, Bruckner T et al (2018) Reverse shoulder arthroplasty for type 1 sequelae of a fracture of the proximal humerus. Bone Joint J 100-B:318–323. https://doi.org/10.1302/0301-620x.100b3.bjj-2017-0947.r1

    Article  CAS  PubMed  Google Scholar 

  17. Raiss P, Aldinger PR, Kasten P et al (2009) Humeral head resurfacing for fixed anterior glenohumeral dislocation. Int Orthop 33:451–456. https://doi.org/10.1007/s00264-007-0487-6

    Article  CAS  PubMed  Google Scholar 

  18. Raiss P, Edwards BT, Collin P et al (2016) Reverse shoulder arthroplasty for malunions of the proximal part of the humerus (type‑4 fracture sequelae). J Bone Joint Surg Am 98:893–899. https://doi.org/10.2106/JBJS.15.00506

    Article  PubMed  Google Scholar 

  19. Raiss P, Edwards BT, Da Silva MR et al (2014) Reverse shoulder arthroplasty for the treatment of nonunions of the surgical neck of the proximal part of the humerus (Type3 Fracture Sequelae). J Bone Joint Surg Am 96:2070–2076. https://doi.org/10.2106/JBJS.N.00405

    Article  PubMed  Google Scholar 

  20. Raiss P, Edwards TB, Bruckner T et al (2017) Reverse arthroplasty for patients with chronic locked dislocation of the shoulder (type 2 fracture sequela). J Shoulder Elbow Surg 26:279–287. https://doi.org/10.1016/j.jse.2016.05.028

    Article  PubMed  Google Scholar 

  21. Resch H, Tauber M, Neviaser RJ et al (2016) Classification of proximal humeral fractures based on a pathomorphologic analysis. J Shoulder Elbow Surg 25:455–462. https://doi.org/10.1016/j.jse.2015.08.006

    Article  PubMed  Google Scholar 

  22. Roux A, Decroocq L, El Batti S et al (2012) Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res 98:715–719. https://doi.org/10.1016/j.otsr.2012.05.013

    Article  CAS  PubMed  Google Scholar 

  23. Schmalzl J, Graf A, Gilbert F et al (2021) Locked fracture dislocations of the proximal humerus : postoperative results and a proposed modification of the classification. Eur J Orthop Surg Traumatol. https://doi.org/10.1007/s00590-021-03022-z

    Article  PubMed  PubMed Central  Google Scholar 

  24. Schmalzl J, Graf A, Kimmeyer M et al (2022) Treatment of avascular necrosis of the humeral head—postoperative results and a proposed modification of the classification. BMC Musculoskelet Disord 23:1–9. https://doi.org/10.1186/s12891-022-05338-1

    Article  CAS  Google Scholar 

  25. Schmalzl J, Jessen M, Gilbert F et al (2020) Proximal humeral fracture morphology in patients with advanced osteoarthritis: an observational study in a surgically treated cohort. J Orthop Surg 28:1–7. https://doi.org/10.1177/2309499020944114

    Article  Google Scholar 

  26. Schmalzl J, Jessen M, Gilbert F et al (2020) Proximal humeral fracture morphology in patients with advanced cuff tear arthropathy: an observational study in a surgically treated cohort. Eur J Orthop Surg Traumatol. https://doi.org/10.1007/s00590-020-02801-4

    Article  PubMed  Google Scholar 

  27. Tauber M, Karpik S, Matis N et al (2007) Shoulder arthroplasty for traumatic avascular necrosis: predictors of outcome. Clin Orthop Relat Res. https://doi.org/10.1097/BLO.0b013e318159cb7a

    Article  PubMed  Google Scholar 

  28. Unbehaun D, Rasmussen S, Hole R et al (2020) Low arthroplasty survival after treatment for proximal humerus fracture sequelae: 3,245 shoulder replacements from the Nordic Arthroplasty Register Association. Acta Orthop. https://doi.org/10.1080/17453674.2020.1793548

    Article  PubMed  PubMed Central  Google Scholar 

  29. Walch G, Badet R, Nové-Josserand L, Levigne C (1996) Nonunions of the surgical neck of the humerus: surgical treatment with an intramedullary bone peg, internal fixation, and cancellous bone grafting. J Shoulder Elbow Surg 5:161–168. https://doi.org/10.1016/S1058-2746(05)80001-1

    Article  CAS  PubMed  Google Scholar 

  30. Walch G, Moraga C, Young A, Castellanos-rosas J (2012) Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg 21:1526–1533. https://doi.org/10.1016/j.jse.2011.11.030

    Article  PubMed  Google Scholar 

  31. Weber BG, Simpson LA, Hardegger F (1984) Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion. J Bone Joint Surg Am 66:1443–1450

    Article  CAS  PubMed  Google Scholar 

  32. Werner BS, Böhm D, Abdelkawi A, Gohlke F (2014) Glenoid bone grafting in reverse shoulder arthroplasty for long-standing anterior shoulder dislocation. J Shoulder Elb Surg 23:1655–1661. https://doi.org/10.1016/j.jse.2014.02.017

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Unfall‑, Hand‑, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland

    J. Schmalzl & J. Habarta

  2. Klinik für Unfall‑, Handchirurgie und Sportmedizin, St. Vincentius Klinik, ViDia Kliniken, Karlsruhe, Deutschland

    J. Schmalzl, A. Graf, M. Kimmeyer, C. Gerhardt & L. J. Lehmann

  3. Abteilung für Orthopädie und Unfallchirurgie, Universitätsklinikum, LMU München, München, Deutschland

    F. Gilbert

  4. Abteilung für Orthopädie und Unfallchirurgie, Universitätsklinikum, TU München, München, Deutschland

    M. Jessen

Authors
  1. J. Schmalzl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Graf
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Habarta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Gilbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Kimmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Jessen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Gerhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. J. Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Schmalzl.

Ethics declarations

Interessenkonflikt

J. Schmalzl, A. Graf, J. Habarta, F. Gilbert, M. Kimmeyer, M. Jessen, C. Gerhardt und L.J. Lehmann geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schmalzl, J., Graf, A., Habarta, J. et al. Ist die Boileau-Klassifikation für Frakturfolgen des proximalen Humerus noch aktuell?. Obere Extremität 18, 3–10 (2023). https://doi.org/10.1007/s11678-022-00718-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11678-022-00718-4

Schlüsselwörter

Keywords

Search

Navigation