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|Klinische Ergebnisse der Behandlung von proximalen Humerusfrakturen|
Matz, Torsten Florian
|Main title||Klinische Ergebnisse der Behandlung von proximalen Humerusfrakturen|
|Subtitle||eine Untersuchung unter besonderer Betrachtung der Lebensqualität|
|Title variations||Clinical results of treatment of proximal humerus fractures|
|Subtitle for translated title||an investigation with special consideration of quality of life|
|Author(s)||Matz, Torsten Florian
Place of birth: Berlin
|1. Referee||Prof. Dr. med. W. Ertel|
|Further Referee(s)||Prof. Dr. med. J. M. Rueger
PD Dr. med. habil. R. A. Laun
|Keywords||proximal humerus fracture; Dash; quality of life|
|Classification (DDC)||610 Medical sciences; Medicine|
|Summary||4-5% of all extremity fractures are proximal humerus fractures. Treatment options are discussed controversial in literature. There are many surgical procedures, such as plate fixation, locking plate fixation, intramedullary osteosynthesis, minimalinvasive procedures, joint replacement, and not least the conservative therapy.
In this work the treatment options used from 2000-2003 at the Charité Campus Benjamin Franklin are evaluated on the basis of objective parameters and an approach based on a self-report-questionnaire (the Dash-test) and discussed in the context of the current international literature.
56 patients were retrospectively examined, questioned and got a new x-ray of the shoulder if they agreed. The average follow-up period was 3.2 years. The median age for women is 76.16 years and for men 60.46 years. According to AO classification 44.6% of study participants had a fracture of Group A, 46.4% a fracture of Group B and 8.9% a fracture of Group C.
When measuring the dimensions of movement in particular the group of endoprostheses showed significant limitations. It reached a median of 60.0 ° of abduction, an anteversion of 65 ° and external rotation of 35 °. The best results were achieved by the conservatively treated patients. They could abduct a median of 152.5 °, had an Anteversion of 145 ° and an external rotation of 57 °. The Dash-test showed with a median of 23.3 points a satisfactory result for the entire population. Outstanding results (median = 4.16 points) could be reached again by the conservatively treated patients. Minimalinvasive osteosynthesis, plates and locking plates showed satisfactory values (median = 19.16 to 24.16 points) and were close together with their results. A bad result was achieved by the group of the endoprosthethesis (median = 48.33 points). 41.1% of patients were pain free at follow-up. 70.8% of the operated patients and 42.8% of patients treated conservatively, which made at the day of follow-up a new radiographic examination, showed radiological criteria for an increase in signs of arthrosis of the shoulder joint. Overall 71.4% of study participants were very satisfied or satisfied with their results of treatment.
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|FU Department||Department of Medicine - Charité - University Medicine Berlin|
|Year of publication||2011|
|Document type||Doctoral thesis|
|Date of defense||2011-09-09|
|Created at||2011-06-07 : 07:07:22|
|Last changed||2011-07-18 : 10:41:32|