Controversies in the Management of Proximal Humerus Fractures.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Nicholas Brule, Yagiz Ozdag, Louis C Grandizio
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引用次数: 0

Abstract

Proximal humerus fractures (PHFs) are frequently encountered by upper-extremity surgeons. Despite recent advances in both surgical techniques and implant designs, numerous management controversies exist that are primarily centered on indications for operative treatment as well as the decision to use fixation techniques or arthroplasty in the management of these injuries in older patients. The introduction and widespread adoption of reverse total shoulder arthroplasty in the management of three- and four-part PHFs represents a paradigm shift with respect to operative treatment options. This review discusses modern management controversies surrounding adult PHFs, including surgical indications, the role of intramedullary nailing and supplemental fixation, as well as timing and techniques for reverse total shoulder arthroplasty to assist surgeons in making evidence-based decisions for management by incorporating results of recent randomized controlled trials assessing treatment outcomes following management of PHFs.

肱骨近端骨折治疗的争议。
肱骨近端骨折(phf)是上肢外科医生经常遇到的。尽管近年来手术技术和植入物设计都取得了进展,但仍存在许多管理上的争议,这些争议主要集中在手术治疗的指征以及在老年患者中使用固定技术或关节置换术来处理这些损伤。在治疗三节段和四节段phf中引入和广泛采用反向全肩关节置换术代表了手术治疗选择的范式转变。这篇综述讨论了围绕成人phf的现代管理争议,包括手术指征、髓内钉和辅助固定的作用,以及反向全肩关节置换术的时机和技术,通过结合最近评估phf管理后治疗结果的随机对照试验的结果,帮助外科医生做出基于证据的管理决策。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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