Zlomeniny proximálneho humeru sú pre ich komplexnosť a menej častý výskyt v relatívnom úzadí traumatológie skeletu. Pozornosť traumatológov je prirodzene viac upriamená na poranenia skeletu dolných končatín. Narastajúci trend v incidencií zlomenín proximálneho humeru však postupne vedie k zvýšenej snahe o pochopenie ich správneho ošetrenie. História liečby zlomenín proximálneho humeru je zaujímavým prehľadom takmer všetkých možností fixácie. Od staroveku bola liečba týchto zlomenín výhradne konzervatívna a spočívala v zatvorenej repozícii a fixácii obväzom. Ani pokroky v chirurgii v druhej polovici 19. storočia neprispeli k výraznejšiemu rozvoju operačnej terapie. Až príchod AO (Arbeitsgemeinschaft für Osteosynthesefragen) školy v druhej polovici 20. storočia, ktoré viedlo k zdokonaleniu princípov osteosyntézy, ako aj pokroky vo vývoji osteosyntetických materiálov, viedol začiatkom 21. storočia k výraznému zlepšeniu možností fixácie zlomenín proximálneho humeru. Aktuálne sme svedkami skutočnosti, že rýchlosť vývoja nových materiálov a možností fixácie výrazne predbieha možnosti sledovania ich efektivity pomocou klinických štúdií.
Proximal humeral fractures find to be less attractive to treat due to their complexity and relatively lower incidence comparing to fractures of lower limb. Increasing incidence of proximal humeral fracture in last decades forced us to seek better solutions on how to treat them. The history of their treatment is an interesting overview of all fixation possibilities. Since ancient times, their treatment has been exclusively conservative, consisting of closed reduction and fixation with a bandage or sling. Even advancements in surgery in second half of the 19th century did not contribute to the greater development of surgical therapy for this type of injuries. Introducing AO school which lead to big advancements in surgical methods of osteosynthesis in second half of the 20th century as well as progress in development in materials lead to great improvements of surgical methods and approaches in treatment of proximal humeral fractures. The development of fixating options continues permanently but we are currently encountering the fact that speed of finding new treatment options precedes it‘s adequate clinical monitoring.
Glenohumeral joint is the most frequently dislocated joint of the human body. Concomitant fractures of the coracoid process and tuberculum majus in humeral dislocation of the shoulder joint are rarely described. Concomitant fractures are results of a significant contraction of the surrounding muscles and rotator cuff during a cerebral paroxysm. Due to the small number of cases, the treatment of such injuries is not simple and it is based on an algorithm for treatment of isolated injuries of these anatomical structures. In this case report, we describe a concomitant fracture of the coracoid process and tuberculum majus during an anterior shoulder dislocation in 25-year-old patient after an epileptic seizure. The injury was treated in our department surgically, with a good functional result. The absolute Constant score for the operated arm is 95 points, the relative Constant score is 97%, DASH score 0, VAS score 0.
- MeSH
- dospělí MeSH
- fraktury kostí * komplikace MeSH
- humerus MeSH
- lidé MeSH
- luxace ramenního kloubu * komplikace chirurgie MeSH
- processus coracoideus MeSH
- ramenní kloub * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
