Nagelosteosynthese proximaler Humerusfrakturen View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-09

AUTHORS

J.C. Katthagen, C. Voigt, Gunnar Jensen, Helmut Lill

ABSTRACT

Die Nagelosteosynthese und Plattenosteosynthese sind anerkannte, teils konkurrierende Operationsverfahren bei dislozierten proximalen Humerusfrakturen. Zunehmende Erkenntnisse über einzelne Implantattypen und postoperative Ergebnisse ermöglichen mittlerweile eine differenzierte Anwendung der Osteosyntheseverfahren. Ideale Indikationen für die Nagelosteosynthese stellen dislozierte subkapitale 2-Segment- (und 3-Segment-) Frakturen sowie in den Schaft reichende Spiralfrakturen dar. Proximale Humerusfrakturen jüngerer Patienten < 60 Jahre eignen sich dagegen aufgrund der Rotatorenmanschettenproblematik ebenso wie 4-Segment-Frakturen besser für die Plattenosteosynthese. Hohe initiale Komplikationsraten können durch die Vermeidung von Anwenderfehlern wie primäre Schraubenperforationen und Beachtung implantatspezifischer Besonderheiten wie den korrekten Eintrittspunkt reduziert werden. Unter korrekter Indikationsstellung werden gute funktionelle klinische Ergebnisse nach Nagelosteosynthese erreicht. Neue arthroskopische Techniken, die Beachtung und Therapie von Begleitpathologien sowie Weiterentwicklungen etablierter Implantate verbessern die Anwendung der Nagelosteosynthese zunehmend und reduzieren bislang kritische Aspekte wie Rotatorenmanschettenaffektionen. More... »

PAGES

128-136

Journal

TITLE

Obere Extremität

ISSUE

3

VOLUME

7

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11678-012-0176-y

DOI

http://dx.doi.org/10.1007/s11678-012-0176-y

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32 schema:description Die Nagelosteosynthese und Plattenosteosynthese sind anerkannte, teils konkurrierende Operationsverfahren bei dislozierten proximalen Humerusfrakturen. Zunehmende Erkenntnisse über einzelne Implantattypen und postoperative Ergebnisse ermöglichen mittlerweile eine differenzierte Anwendung der Osteosyntheseverfahren. Ideale Indikationen für die Nagelosteosynthese stellen dislozierte subkapitale 2-Segment- (und 3-Segment-) Frakturen sowie in den Schaft reichende Spiralfrakturen dar. Proximale Humerusfrakturen jüngerer Patienten < 60 Jahre eignen sich dagegen aufgrund der Rotatorenmanschettenproblematik ebenso wie 4-Segment-Frakturen besser für die Plattenosteosynthese. Hohe initiale Komplikationsraten können durch die Vermeidung von Anwenderfehlern wie primäre Schraubenperforationen und Beachtung implantatspezifischer Besonderheiten wie den korrekten Eintrittspunkt reduziert werden. Unter korrekter Indikationsstellung werden gute funktionelle klinische Ergebnisse nach Nagelosteosynthese erreicht. Neue arthroskopische Techniken, die Beachtung und Therapie von Begleitpathologien sowie Weiterentwicklungen etablierter Implantate verbessern die Anwendung der Nagelosteosynthese zunehmend und reduzieren bislang kritische Aspekte wie Rotatorenmanschettenaffektionen.
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