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Arthroskopisch unterstütztes Frakturmanagement am proximalen Humerus

Arthroscopic fracture management in proximal humeral fractures

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Zusammenfassung

Die Arthroskopie hat sich in der Versorgung proximaler Humerusfrakturen zunehmend etabliert. Neben den bekannten Vorteilen minimal-invasiver Techniken können hier zusätzlich die Frakturstellung und Implantatlage arthroskopisch optimiert und kontrolliert werden. Bisher wenig beachtete relevante intraartikuläre Begleitverletzungen (Bizepssehnenkomplex, Rotatorenmanschette) werden diagnostiziert und therapiert. Arthroskopische Techniken haben sich als vorteilhaft in der Behandlung von Tuberculum-majus-Frakturen verschiedener Entitäten (arthroskopisch kontrollierte Schraubenosteosynthese, Suture-bridging-Technik), von Tuberculum-minus-Frakturen (Suture-bridging-Technik) sowie von subkapitalen Humerusfrakturen (arthroskopische Nagelosteosynthese) erwiesen. Dieser Beitrag liefert eine Übersicht über die aktuellen arthroskopischen Versorgungsmöglichkeiten am proximalen Humerus und stellt die Operationstechniken, Vorteile gegenüber offenen Verfahren sowie erste Ergebnisse dar.

Abstract

Arthroscopy has become increasingly more established in the treatment of proximal humeral fractures. In addition to the known advantages of minimally invasive surgery fracture and implant positioning can be optimized and controlled arthroscopically and relevant intra-articular concomitant pathologies (e.g. biceps tendon complex and rotator cuff) can be diagnosed and treated. Arthroscopic techniques have proven to be advantageous in the treatment of various entities of greater tuberosity fractures, lesser tuberosity fractures (suture bridging technique) and subcapital humeral fractures (arthroscopic nailing). This article presents an overview on innovative arthroscopic modalities for treating proximal humeral fractures, describes the surgical techniques and the advantages compared to open procedures as well as initial clinical results.

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Authors and Affiliations

  1. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Humboldtstraße 5, 30169, Hannover, Deutschland

    H. Lill, C. Katthagen, G. Jensen & C. Voigt

  2. Komitee TRAUMA der AGA, Gesellschaft für Arthroskopie und Gelenkchirurgie, Wien, Österreich

    H. Lill & C. Voigt

Authors
  1. H. Lill
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  2. C. Katthagen
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  3. G. Jensen
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  4. C. Voigt
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Correspondence to H. Lill.

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Lill, H., Katthagen, C., Jensen, G. et al. Arthroskopisch unterstütztes Frakturmanagement am proximalen Humerus. Unfallchirurg 116, 296–304 (2013). https://doi.org/10.1007/s00113-012-2345-2

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  • DOI: https://doi.org/10.1007/s00113-012-2345-2

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