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[Post-traumatic necrosis of the humeral head-Endoprosthesis or joint preservation]
A Wegner1,2, D Wassenaar3,4, A Busch3,4
1Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland. alexander.wegner@klinikum.wolfsburg.de.
Background:
Humerus fractures play a major role in daily clinical routine, and subsequent osteonecrosis is common after osteosyntheses.
Objectives:
The current paper highlights the incidence and cause of osteonecrosis after proximal humerus fractures, with respect to presentation of anatomy and risk factors.
Methods:
Display of the literature and therapy options for humerus fracture and subsequent necrosis.
Results:
Humerus fractures are the seventh most frequent fractures in humans. The complication rate is 40%, and the described rate of necrosis is up to 34%. Accordingly, the surgical revision rate is at 19% according to recent literature.
Conclusion:
The treatment of humerus head fracture must consider numerous variables. The individual type of fracture and the current individual situation of the patient must be included in the process of choosing the right treatment. Modern implants with screw locking features should be used, and for certain circumstances the direct implantation of a prosthesis should be considered. Thereby the expectations of the patient with respect to the postoperative activity level play a major role.
