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Frakturbiologie und -morphologie

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Die proximale Humerusfraktur

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Zusammenfassung

Im Rahmen der Frakturheilung nehmen in erster Linie biologische Faktoren eine zentrale Rolle ein. Dies gilt sowohl für die konservative als auch für die operative Frakturbehandlung. Bei der operativen Versorgung gewinnen zusätzlich mechanische und implantatspezifische Faktoren an Bedeutung. Aus biologischer Sicht ist die Vaskularität prioritär zu betrachten. Knochenbruchheilung setzt eine suffiziente Durchblutung der Fragmente voraus. Demineralisierung mit Remodeling von kortikalem und spongiösem Knochengewebe, fibroblastische Organisation des Frakturhämatoms, Kallusformation und Neoangiogenese sind biologische Prozesse im Rahmen der Frakturkonsolidierung, bei denen eine intakte Vaskularisation Grundvoraussetzung ist. Daher ist eine gewisse Kenntnis der Humeruskopfdurchblutung essenziell, um das Risiko einer posttraumatischen avaskulären Kopfnekrose besser einschätzen zu können sowie relevante Strukturen im Rahmen einer kopferhaltenden operativen Versorgung zu schonen und zu wahren.

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Authors and Affiliations

  1. Paracelsus Medizinische Universität Salzburg, Müllner-Hauptstraße 48, 5020, Salzburg, Österreich

    Herbert Resch Univ. -Prof. Dr. med.

  2. ATOS Klinik München, Effnerstraße 38, 81925, München, Deutschland

    Mark Tauber PD Dr. med.

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  1. Mark Tauber PD Dr. med.
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  2. Herbert Resch Univ. -Prof. Dr. med.
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Editors and Affiliations

  1. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Germany

    Helmut Lill

  2. Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Markus Scheibel

  3. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Germany

    Christine Voigt

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Tauber, M., Resch, H. (2014). Frakturbiologie und -morphologie. In: Lill, H., Scheibel, M., Voigt, C. (eds) Die proximale Humerusfraktur. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35257-7_1

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