Untersuchung im Rahmen der Qualitätssicherung bei der Versorgung von Humeruskopffrakturen

Study in order of quality assurance for the treatment of fractures of the humeral head

by Tobias Himmelmann
Doctoral thesis
Date of Examination:2014-11-18
Date of issue:2014-11-06
Advisor:Prof. Dr. Klaus Dresing
Referee:Prof. Dr. Hans-Michael Klinger
Referee:Prof. Dr. Martin Oppermann
Persistent Address: http://dx.doi.org/10.53846/goediss-4763

 

 

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Abstract

English

408 Patients, who suffered a fracture of the humeral head and who were treated in the UMG of Göttingen between 1995 and 2011 were included in this study. The purpose was to assure a certain standard of quality in the operative treatment of fractures of the humeral neck and to find out circumstances, which may be able to predict a failure of the osteosynthesis. The changes of the Tip-Apex-Distance and density of the humeral head in comparison to the glenoid over time were selected as objective parameters to quantify the failure of the operative treatment. Over the whole collective of patients, the changes in Tip-Apex-Distance were highly significant, while the changes in the density have not been found to be statistically significant. Of all of the examined parameters, mainly a metabolic syndrome, a history of orthopedic surgery or alcoholism were found to lead to a failure of the surgical treatment. A high-normal BMI and the use of a Continuous-Passive-Motion-Device were found to be protective. One of the most important factors and highly significant is a stable medial part of the humeral neck, which is referred to as the calcar of the humerus.  
Keywords: humeral neck fractures
Schlagwörter: Humeruskopffrakturen
 
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