СОВРЕМЕННЫЕ МЕТОДЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ И ДИАГНОСТИКИ ПЕРЕЛОМОВ ПРОКСИМАЛЬНОГО ОТДЕЛА ПЛЕЧЕВОЙ КОСТИ. ОБЗОР ЛИТЕРАТУРЫ.
Актуальность: Переломы проксимального отдела плечевой кости в большинстве случаев являются сложными повреждениями, при которых часто наблюдается раздробление на множество костных фрагментов, смещение отломков в различных направлениях из-за тяги мышц ротаторов, переломо-вывихи головки плеча. Так же нередко повреждение сосудов, питающих головку плеча и подмышечного нерва. Классификация данных травм и методы лечения продолжают совершенствоваться. В данном обзоре представлены такие вопросы, как: эпидемиология, классификации, диагностика, различные методы хирургического лечения переломов проксимального отдела плечевой кости. Цель: Провести анализ литературных данных о диагностике и современных хирургических методах лечения переломов проксимального отдела плечевой кости. Стратегия поиска: Проведен поиск и анализ научных публикаций в базах данных и web-ресурсах PubMed, EMBASE, Web of Science, Cochrane Library, MEDLINE, Google Scholar, Cyberleninka и электронной библиотеке eLIBRARY. Временной период был обозначен 2014 - 2020 годами. Преимущество отдавалось публикациям рецензируемых изданий. В результате первичной выборки определены 391 литературных источника, из которых 95 публикаций были выбраны в качестве материала для данной статьи. Критерии включения: отчеты о рандомизированных и когортных исследованиях, систематические обзоры и метаанализы, протоколы диагностики и лечения, статьи на английском и русском языках. Критерии исключения: личные сообщения, газетные публикации, тезисы, статьи с нечеткими выводами. Результаты и выводы: Результаты литературного обзора публикаций зарубежных и отечественных авторов свидетельствуют об отсутствии «золотого стандарта» хирургического лечения переломов проксимального отдела плечевой кости. На сегодняшний день существуют различные импланты и способы оперативного лечения, разрабатываются новые способы фиксации. Но нет единого метода, способного обеспечить стабильную фиксацию различных видов переломов проксимального отдела плеча. До сих пор в мире продолжаются дискуссии между сторонниками остеосинтеза и первичного эндопротезирования перелома. Не существует универсального алгоритма лечения, учитывающего индивидуальные качества каждого пострадавшего. Вышеуказанные данные подверждают актуальность дальнейшего поиска и разработки новых методов хирургического лечения сложных переломов проксимальной части плечевой кости. Ключевые слова: переломы проксимального отдела плечевой кости, блокируемая пластина, классификация Neer, эндопротезирование плечевого сустава.
Арман С. Мусабеков1, https://orcid.org/0000-0001-8618-0345 Ерсин Т. Жунусов1, https://orcid.org/0000-0002-1182-5257 Айдос С. Тлемисов1, https://orcid.org/0000-0002-4239-6627 Ернар Н. Токтаров1, https://orcid.org/0000-0002-5166-243X Талгат Г. Джунусов1, https://orcid.org/0000-0001-8169-147X Адлет M. Каламов1, https://orcid.org/0000-0002-4576-0658 1 НАО «Медицинский университет Семей», г. Семей, Республика Казахстан.
1. Аскерко Э.А. Практическая хирургия ротаторной манжеты плеча. Витебск 2005, 202 с. 2. Григорьев А.В. Хирургическое лечение переломов проксимального отдела плечевой кости // Диссертация на соискание ученой степени кандидата медицинских наук. 14.01.15. 2019. – 240с. 3. Кавалерский Г.М., Мурылев В.Ю., Имамкулиев А.Ч., Рукин Я.А. Тактика хирургического лечения внесуставных переломов проксмального отдела плечевой кости // Клинические исследования. 2016. 3(19):5–12. 4. Aguado H.J., Mingo J., Torres M., Alvarez-Ramos A., Martín-Ferrero M.A. Minimally invasive polyaxial locking plate osteosynthesis for 3–4 part proximal humeral fractures: our institutional experience // Injury. 2016. 47:S22–8. 5. Arumugam S., Arumugam V., Raviraman V. Surgical management of proximal humerus fracture treated with locking compression plate // Int J Res Orthop. 2017;3(6):1165. 6. Assefa N., Yosief T. Human Anatomy and Physiology (Lectures Notes) // Ephti. 2003;428. 7. Barlow J.D., Logli A.L., Steinmann S.P., Sems S.A., Cross W.W., Yuan B.J., et al. Locking plate fixation of proximal humerus fractures in patients older than 60 years continues to be associated with a high complication rate // J Shoulder Elb Surg. 2020;29(8). 8. Beeres FJP, Hallensleben NDL, Rhemrev S.J., Goslings J.C., Oehme F., Meylaerts SAG, et al. Plate fixation of the proximal humerus: an international multicentre comparative study of postoperative complications // Arch Orthop Trauma Surg. 2017;137(12):1685–92. 9. Beks R.B., Ochen Y., Frima H., Smeeing DPJ, van der Meijden O., Timmers T.K., et al. Operative versus nonoperative treatment of proximal humeral fractures: a systematic review, meta-analysis, and comparison of observational studies and randomized controlled trials. // Journal of Shoulder and Elbow Surgery. Vol. 27, 2018. p. 1526–34. 10. Bergdahl C., Ekholm C., Wennergren D., Nilsson F., Möller M. Epidemiology and patho-anatomical pattern of 2,011 humeral fractures: Data from the Swedish Fracture Register // BMC Musculoskelet Disord. 2016;17(1). 11. Bohsali K.I., Bois A.J., Wirth M.A. Complications of shoulder arthroplasty // J Bone Jt Surg. 2017;99(3):256–69. 12. Boileau P. Complications and revision of reverse total shoulder arthroplasty // Orthop Traumatol Surg Res. 2016.102(1):S33–43. 13. Bouchet R., Block D., D’ollonne T., Gadea F., Gaillot J., Sirveaux F., et al. Non-operative treatment of four-part fractures of the proximal end of the humerus: results of a prospective and retrospective multicentric study // Int Orthop. 2016;40(8):1669–74. 14. Cappellari A., Trovarelli G., Andriolo M., Berizzi A., Ruggieri P. Reverse shoulder arthroplasty for treatment of proximal humerus complex fractures in elderly: A single institution experience. Injury. 2020; 15. Carbone S., Papalia M. The amount of impaction and loss of reduction in osteoporotic proximal humeral fractures after surgical fixation // Osteoporos Int. 2016;27(2):627–33. 16. Chae J., Siljander M., Michael Wiater J. Instability in reverse total shoulder arthroplasty // J Am Acad Orthop Surg. 2018;26(17):587–96. 17. Chivot M., Lami D., Bizzozero P., Galland A., Argenson J.N. Three- and four-part displaced proximal humeral fractures in patients older than 70 years: reverse shoulder arthroplasty or nonsurgical treatment? // J Shoulder Elb Surg [Internet]. 2019;28(2):252–9. 18. Ciric D., Mischler D., Qawasmi F., Wenzel L., Richards R.G., Gueorguiev B., et al. Secondary Perforation Risk in Plate Osteosynthesis of Unstable Proximal Humerus Fractures: A Biomechanical Investigation of the Effect of Screw Length // J Orthop Res. 2019;37(12):2625–33. 19. Clinton J., Franta A., Polissar N.L., Neradilek B., Mounce D., Fink H.A., et al. Proximal humeral fracture as a risk factor for subsequent hip fractures // J Bone Jt Surg - Ser A. 2009;91(3):503–11. 20. Cole B.J., Katolik L.I. Shoulder. http://www.pacificaorthopedics.org/downloads/sek/sa.pdf. (Дата обращения 11.2021) 21. Cowling P.D., Holland P., Kottam L., Baker P., Rangan A. Risk factors associated with intraoperative complications in primary shoulder arthroplasty: A study using the England, Wales and Northern Ireland National Joint Registry dataset // Acta Orthop. 2017;88(6):587–91. 22. Critchley O., McLean A., Page R., Taylor F., Graves S., Lorimer M., et al. Reverse total shoulder arthroplasty compared to stemmed hemiarthroplasty for proximal humeral fractures: a registry analysis of 5946 patients // J Shoulder Elb Surg. 2020;29(12). 23. Cvetanovich G.L., Chalmers P.N., Verma N.N., Nicholson G.P., Romeo A.A. Open reduction internal fixation has fewer short-term complications than shoulder arthroplasty for proximal humeral fractures // J Shoulder Elb Surg [Internet]. 2016;25(4):624-631.e3. 24. Deepak C.D., Ravoof A., Baruah M.J. Functional outcome of displaced proximal humerus fractures managed by proximal humerus interlocking system plate // Int J Res Orthop. 2017;3(3):583. 25. Dilisio M.F., Nowinski R.J., Hatzidakis A.M., Fehringer E.V. Intramedullary nailing of the proximal humerus: Evolution, technique, and results // J Shoulder Elb Surg [Internet]. 2016;25(5):e130–8. 26. Dillon M.T., Prentice H.A., Burfeind W.E., Chan P.H., Navarro R.A. The increasing role of reverse total shoulder arthroplasty in the treatment of proximal humerus fractures // Injury [Internet]. 2019;50(3):676–80. 27. Donohue D.M., Santoni B.G., Stoops T.K., Tanner G., Diaz M.A., Mighell M. Biomechanical Comparison of 3 Inferiorly Directed Versus 3 Superiorly Directed Locking Screws on Stability in a 3-Part Proximal Humerus Fracture Model // J Orthop Trauma. 2018;32(6):306–12. 28. Doursounian L., Le Sant A., Mauprivez R., Miquel A., Beauthier-Landauer V. Open reduction and internal fixation of three- and four-part proximal humeral fractures by intra-focal distraction: observational study of twenty five cases // Int Orthop. 2016;40(11):2373–82. 29. Ernstbrunner L., Rahm S., Suter A., Imam M.A., Catanzaro S., Grubhofer F., et al. Salvage reverse total shoulder arthroplasty for failed operative treatment of proximal humeral fractures in patients younger than 60 years: long-term results // J Shoulder Elb Surg. 2020;29(3):561–70. 30. Fain A.M., Vaza A.Y., Slastinin V.V., Titov R.S. Diagnosis and treatment of proximal humerus fractures // Sklifosovsky J Emerg Med Care. 2018;7(2):144–51. 31. Feissli S., Audigé L., Steinitz A., Müller A.M., Rikli D. Treatment options for proximal humeral fractures in the older adults and their implication on personal independence // Arch Orthop Trauma Surg. 2020;140(12). 32. Fletcher JWA, Windolf M., Richards R.G., Gueorguiev B., Buschbaum J., Varga P. Importance of locking plate positioning in proximal humeral fractures as predicted by computer simulations // J Orthop Res. 2019;37(4):957–64. 33. Fletcher JWA, Windolf M., Grünwald L., Richards R.G., Gueorguiev B., Varga P. The influence of screw length on predicted cut-out failures for proximal humeral fracture fixations predicted by finite element simulations // Arch Orthop Trauma Surg. 2019;139(8):1069–74. 34. Frima H., Michelitsch C., Beks R.B., Houwert R.M., Acklin Y.P., Sommer C. Long-term follow-up after MIPO Philos plating for proximal humerus fractures // Arch Orthop Trauma Surg [Internet]. 2019;139(2):203–9. 35. Gracitelli MEC, Dotta TAG, Assunção J.H., Malavolta E.A., Andrade-Silva F.B., Kojima KE, et al. Intraobserver and interobserver agreement in the classification and treatment of proximal humeral fractures // J Shoulder Elb Surg. 2017;26(6):1097–102. 36. Gregory T.M., Vandenbussche E., Augereau B. Surgical treatment of three and four-part proximal humeral fractures // Orthop Traumatol Surg Res [Internet]. 2013;99(1):S197–207. 37. Grubhofer F., Wieser K., Meyer D.C., Catanzaro S., Schürholz K., Gerber C. Reverse total shoulder arthroplasty for failed open reduction and internal fixation of fractures of the proximal humerus // J Shoulder Elb Surg [Internet]. 2017;26(1):92–100. 38. Haasters F., Siebenbürger G., Helfen T., Daferner M., Böcker W., Ockert B. Complications of locked plating for proximal humeral fractures—are we getting any better? J Shoulder Elb Surg. 2016;25(10):e295–303. 39. Hak D.J., Fader R., Baldini T., Chadayammuri VBS. Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates // Int Orthop. 2017;41(9):1735–9. 40. Han R.J., Sing D.C., Feeley B.T., Ma C.B., Zhang A.L. Proximal humerus fragility fractures: Recent trends in nonoperative and operative treatment in the Medicare population // J Shoulder Elb Surg [Internet]. 2016;25(2):256–61. 41. Harnoß T., Weigl M., Schreiber U., Täger G., Lenich A. OS3-18 Treatment of proximal humeral fractures in Germany: a representative survey // Injury [Internet]. 2016;47:S8. 42. Harshwardhan H., Verma B.P. Functional outcome of proximal humerus fracture treated with proximal humerus interlocking system plating // Int J Res Orthop. 2019;5(5):936. 43. Hasan A.P., Phadnis J., Jaarsma R.L., Bain G.I. Fracture line morphology of complex proximal humeral fractures // J Shoulder Elb Surg. 2017;26(10):e300–8. 44. Helfen T., Siebenbürger G., Mayer M., Böcker W., Ockert B., Haasters F. Operative treatment of 2-part surgical neck fractures of the proximal humerus (AO 11-A3) in the elderly: Cement augmented locking plate PhilosTM vs. proximal humerus nail MultiLoc®. BMC Musculoskelet Disord. 2016;17(1):1–7. 45. Hengg C., Nijs S., Klopfer T., Jaeger M., Platz A., Pohlemann T., et al. Cement augmentation of the proximal humerus internal locking system in elderly patients: a multicenter randomized controlled trial // Arch Orthop Trauma Surg. 2019;139(7):927–42. 46. Hohenberger G.M., Schwarz A.M., Dauwe J., Grechenig P., Staresinic M., Feigl G., et al. Evaluation of screw placement in proximal humerus fractures regarding drilling manoeuvre and surgeon’s experience // Injury. 2020;(xxxx):7–11. 47. Howard L., Berdusco R., Momoli F., Pollock J., Liew A., Papp S., et al. Open reduction internal fixation vs non-operative management in proximal humerus fractures: A prospective, randomized controlled trial protocol // BMC Musculoskelet Disord. 2018;19(1). 48. Hudgens J.L., Jang J., Aziz K., Best M.J., Srikumaran U. Three- and 4-part proximal humeral fracture fixation with an intramedullary cage: 1-year clinical and radiographic outcomes // J Shoulder Elb Surg. 2019;28(6):S131–7. 49. Jacob T.T., Nayak M. Functional outcome of patients treated with proximal humeral internal locking osteosynthesis plate in proximal humeral fractures // Int J Res Orthop. 2020;6(6). 50. Katthagen J.C., Schwarze M., Warnhoff M., Voigt C., Hurschler C., Lill H. Influence of plate material and screw design on stiffness and ultimate load of locked plating in osteoporotic proximal humeral fractures // Injury. 2016;47(3):617–24. 51. Kim H., Chung Y.G., Jang J.S., Kim Y., Park S. Bin, Song H.S. Why locking plates for the proximal humerus do not fit well // Arch Orthop Trauma Surg. 2020, 212 p. 52. Kim D.S., Lee D.H., Chun Y.M., Shin S.J. Which additional augmented fixation procedure decreases surgical failure after proximal humeral fracture with medial comminution: fibular allograft or inferomedial screws? // J Shoulder Elb Surg. 2018;27(10):1852–8. 53. Kirsch J.M., Khan M., Thornley P., Gichuru M., Freehill M.T., Neviaser A., et al. Platform shoulder arthroplasty: a systematic review // J Shoulder Elb Surg. 2018;27(4):756–63. 54. Kloub M., Holub K., Urban J., Látal P., Peml M., Křivohlávek M. Intramedullary nailing of displaced four-part fractures of the proximal humerus // Injury. 2019;50(11):1978–85. 55. Klug A., Wincheringer D., Harth J., Schmidt-Horlohé K., Hoffmann R., Gramlich Y. Complications after surgical treatment of proximal humerus fractures in the elderly—an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating // J Shoulder Elb Surg. 2019;28(9):1674–84. 56. Knierzinger D., Crepaz-Eger U., Hengg C., Kralinger F. Does cement augmentation of the screws in angular stable plating for proximal humerus fractures influence the radiological outcome: a retrospective assessment // Arch Orthop Trauma Surg. 2020;140(10). 57. Kulkarni S., Kulkarni A., Patel A., Gupta T. Proximal humerus fractures operated with PHILOS plate: 4 year prospective study // Int J Res Orthop. 2017;3(2):304. 58. Kumar R., Natarajan S., Kumar S., Kalanithi R. Outcome analysis of patients with proximal humerus fractures treated with locking plates // Int J Res Orthop. 2017;3(3):401. 59. LaMartina J., Christmas K.N., Simon P., Streit J.J., Allert J.W., Clark J., et al. Difficulty in decision making in the treatment of displaced proximal humerus fractures: the effect of uncertainty on surgical outcomes // J Shoulder Elb Surg [Internet]. 2018;27(3):470–7. 60. Launonen A.P., Lepola V., Saranko A., Flinkkilä T., Laitinen M., Mattila V.M. Epidemiology of proximal humerus fractures // Arch Osteoporos. 2015;10(1):1–5. 61. Lee S.Y., Kwon S.S., Kim T.H., Shin S.J. Is central skeleton bone quality a predictor of the severity of proximal humeral fractures? Injury [Internet]. 2016;47(12):2777–82. 62. Lin D.J., Wong T.T., Kazam J.K. Shoulder arthroplasty, from indications to complications: What the radiologist needs to know // Radiographics. 2016;36(1):192–208. 63. Liu J.N., Agarwalla A., Gowd A.K., Romeo A.A., Forsythe B., Verma N.N., et al. Reverse shoulder arthroplasty for proximal humerus fracture: a more complex episode of care than for cuff tear arthropathy // J Shoulder Elb Surg. 2019;28(11):2139–46. 64. Lopiz Y., Garríguez-Pérez D., Martínez-Illán M., García-Fernández C., Marco F. Third-generation intramedullary nailing for displaced proximal humeral fractures in the elderly: quality of life, clinical results, and complications // Arch Orthop Trauma Surg. 2020; 65. Maier D., Jaeger M., Izadpanah K., Strohm P.C., Suedkamp N.P. Proximal Humeral Fracture Treatment in Adults // J Bone Jt Surg. 2014;96(3):251–61. 66. Mazzucchelli R.A., Jenny K., Zdravkovic V., Erhardt J.B., Jost B., Spross C. The influence of local bone quality on fracture pattern in proximal humerus fractures // Injury [Internet]. 2018;49(2):359–63. 67. Mehta S., Chin M., Sanville J., Namdari S., Hast M.W. Calcar screw position in proximal humerus fracture fixation: Don’t miss high! // Injury. 2018;49(3):624–9. 68. Meselhy M.A., Singer M.S. Management of proximal humeral fractures by the Ilizarov external fixator // Arch Orthop Trauma Surg. 2017;137(9):1279–84. 69. Nowak L.L., Vicente M.R., McKee M.D., Hall J.A., Nauth A., Schemitsch E.H. Orthopaedic surgeons’ opinions surrounding the management of proximal humerus fractures: an international survey // Int Orthop. 2017;41(9):1749–55. 70. Padegimas E.M., Zmistowski B., Lawrence C., Palmquist A., Nicholson T.A., Namdari S. Defining optimal calcar screw positioning in proximal humerus fracture fixation // J Shoulder Elb Surg. 2017;26(11):1931–7. 71. Padolino A., Porcellini G., Guollo B., Fabbri E., Kumar GNK, Paladini P., et al. Comparison of CFR-PEEK and conventional titanium locking plates for proximal humeral fractures: a retrospective controlled study of patient outcomes // Musculoskelet Surg. 2018;102(s1):49–56. 72. Panchal K., Jeong J.J., Park S.E., Kim W.Y., Min H.K., Kim J.Y., et al. Clinical and radiological outcomes of unstable proximal humeral fractures treated with a locking plate and fibular strut allograft // Int Orthop. 2016;40(3):569–77. 73. Passaretti D., Candela V., Sessa P., Gumina S. Epidemiology of proximal humeral fractures: a detailed survey of 711 patients in a metropolitan area // J Shoulder Elb Surg. 2017;26(12):2117–24. 74. Roberson T.A., Granade C.M., Hunt Q., Griscom J.T., Adams K.J., Momaya A.M., et al. Nonoperative management versus reverse shoulder arthroplasty for treatment of 3- and 4-part proximal humeral fractures in older adults // J Shoulder Elb Surg. 2017;26(6):1017–22. 75. Russo R., Guastafierro A., Pietroluongo L.R. A morphovolumetric study of head malposition in proximal humeral fractures based on 3-dimensional computed tomography scans: the control volume theory // J Shoulder Elb Surg. 2018;27(5):940–9. 76. Russo R., Guastafierro A., Rotonda G. della, Viglione S., Ciccarelli M., Mortellaro M., et al. A new classification of impacted proximal humerus fractures based on the morpho-volumetric evaluation of humeral head bone loss with a 3D model // J Shoulder Elb Surg. 2020;29(10):e374–85. 77. Russo R., D’Auria D., Ciccarelli M., Della Rotonda G., D’Elia G., Siciliano B. Triangular block bridge method for surgical treatment of complex proximal humeral fractures: theoretical concept, surgical technique and clinical results // Injury. 2017;48:S12–9. 78. Schumaier A., Grawe B. Proximal Humerus Fractures : Evaluation and Management in the Elderly Patient. 2018;9:1–11. 79. Seetharam C.T., Jayaram M., Bachhappa S.H., Ramalingaiah Y., Hadi S.A. Study of surgical management of fracture of proximal humerus by PHILOS plate and screws // Int J Res Orthop. 2020;6(3):462. 80. Seidl A.J., Sholder D., Warrender W., Livesey M.G., Williams G.R., Abboud J.A., et al. Early vs. late reverse shoulder arthroplasty for proximal humerus fractures: does it matter? // J Shoulder Elb Surg [Internet]. 2017;26(10):e333–4. 81. Shi X., Liu H., Xing R., Mei W., Zhang L., Ding L., et al. Effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture: An update systematic review and meta-analysis // J Orthop Surg Res. 2019;14(1):1–11. 82. Shukla D.R., McAnany S., Pean C., Overley S., Lovy A., Parsons B.O. The results of tension band rotator cuff suture fixation of locked plating of displaced proximal humerus fractures // Injury. 2017;48(2):474–80. 83. Sohn H.S., Jeon Y.S., Lee J.H., Shin S.J. Clinical comparison between open plating and minimally invasive plate osteosynthesis for displaced proximal humeral fractures: A prospective randomized controlled trial. Injury. 2017;48(6):1175–82. 84. Spross C., Meester J., Mazzucchelli R.A., Puskás G.J., Zdravkovic V., Jost B. Evidence-based algorithm to treat patients with proximal humerus fractures—a prospective study with early clinical and overall performance results // J Shoulder Elb Surg. 2019;28(6):1022–32. 85. Spross C., Zeledon R., Zdravkovic V., Jost B. How bone quality may influence intraoperative and early postoperative problems after angular stable open reduction–internal fixation of proximal humeral fractures // J Shoulder Elb Surg. 2017;26(9):1566–72. 86. Subash Y., M. L, K. K, Dhamu I.M. An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system // Int J Res Orthop. 2017;4(1):46. 87. Sukthankar A.V., Leonello D.T., Hertel R.W., Ding G.S., Sandow M.J. A comprehensive classification of proximal humeral fractures : HGLS system // J Shoulder Elb Surg. 2013;22(7):e1–6. 88. Tadvi N.D., Deveshawar R.N., Patel Y.C. Treatment of proximal humerus fracture using proximal humerus locking plating // Int J Res Orthop. 2017;3(4):670. 89. Vachtsevanos L., Hayden L., Desai A.S., Dramis A. Management of proximal humerus fractures in adults. 2014;5(5):685–93. 90. Valenti P., Zampeli F., Ciais G., Kany J., Katz D. The initial treatment of complex proximal humerus fracture affects the outcome of revision with reverse shoulder arthroplasty. Int Orthop. 2020;44(7). 91. Varga P., Grünwald L., Windolf M. The prediction of cyclic proximal humerus fracture fixation failure by various bone density measures. J Orthop Res. 2018;36(8):2250–8. 92. Venkat Kavuri, Blake Bowden, Neil Kumar and DC. Complications Associated with Locking Plate of Proximal Humerus Fractures. Indian J Orthop. 2018;2(5):108–116. 93. Von Rüden C, Augat P. Failure of fracture fixation in osteoporotic bone. Injury [Internet]. 2016;47:S3–10. 94. Yahuaca B.I., Simon P., Christmas K.N., Patel S., Gorman R.A., Mighell M.A., et al. Acute surgical management of proximal humerus fractures: ORIF vs. hemiarthroplasty vs. reverse shoulder arthroplasty. J Shoulder Elb Surg [Internet]. 2020;29(7):S32–40. 95. Zhang Y.K., Wei H.W.et al. Biomechanical effect of the configuration of screw hole style on locking plate fixation in proximal humerus fracture with a simulated gap: A finite element analysis. Injury. 2016;47(6):1191–5. References: 1. Askerko Je.A. Prakticheskaya khirurgiya rotatornoi manzhety plecha [Practical surgery of the rotator cuff of the shoulder]. Vitebsk 2005.,220p. [in Russian] 2. Grigor'ev A. V. Khirurgicheskoe lechenie perelomov proksimal'nogo otdela plechevoi kosti [Surgical treatment of fractures of the proximal humerus]. Cand. dissertation [Kand dissert]. (14.01.15.), 2019, 240p. [in Russian] 3. Kavalerskij G.M., Murylev V.Ju., Imamkuliev A.Ch., Rukin Ja.A. Taktika khirurgicheskogo lecheniya vnesustavnykh perelomov proksmal'nogo otdela plechevoi kosti [Tactics of surgical treatment of extra-articular fractures of the proximal humerus]. Klinicheskie issledovaniya [Clinical researches], Moskva 2016.;3(19):5–12. [in Russian]
Количество просмотров: 13

Ключевые слова:

Библиографическая ссылка

Мусабеков А.С., Жунусов Е.Т., Тлемисов А.С., Токтаров Е.Н., Джунусов Т.Г., Каламов А.M. Современные методы хирургического лечения и диагностики переломов проксимального отдела плечевой кости. Обзор литературы // Наука и Здравоохранение. 2022. 3(Т.24). С. 159-170. doi 10.34689/SH.2022.24.3.019 Mussabekov A.С., Zhunussov Ye.T., Tlemisov A.S., Toktarov E.N., Dzhunusov T.G., Kalamov A.M. Modern methods of surgical treatment and diagnosis of the proximal humerus fractures. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 3, pp. 159-170. doi 10.34689/SH.2022.24.3.019 Мусабеков А.С., Жунусов Е.Т., Тлемисов А.С., Токтаров Е.Н., Джунусов Т.Г., Каламов А.M. Тоқпан жіліктің проксимальды бөлігі сынықтарынын хирургиялық емінің және диагностикасынын заманауи әдістері. Әдебиетке шолу // Ғылым және Денсаулық сақтау. 2022. 3 (Т.24). Б. 159-170. doi 10.34689/SH.2022.24.3.019