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Gãy xương cánh tay đầu gần chỗ

Thành công điều trị gãy xương cánh tay gần dựa vào khả năng của bác sĩ phẫu thuật để làm cho một chẩn đoán chính xác. Việc điều trị phải được xác định trên một sự hiểu biết thấu đáo về giải phẫu vai phức tạp, một đánh giá chính xác chụp ảnh phóng xạ | Displaced Proximal Humeral Fractures Evaluation and Treatment Theodore F. Schlegel MD and Richard J. Hawkins MD FRCS C Abstract Successful treatment of proximal humeral fractures relies on the surgeon s ability to make an accurate diagnosis. Treatment must be predicated on a thorough understanding of the complex shoulder anatomy a precise radiographic evaluation and use of a well-designed classification system. Appropriate and realistic goals must be established for each patient. The patient s general medical health physiologic age and ability to cooperate with intense and prolonged rehabilitation are all considerations when selecting the optimal treatment. J Am Acad Orthop Surg 1994 2 54-66 The majority of patients who sustain proximal humeral fractures are in the middle and older age groups.1-3 In younger patients these fractures are often the result of high-energy injuries. Osteoporosis plays a significant role in the older sedentary patient.4 5 The proximal humerus becomes more susceptible to fracture with age because of the structural changes that occur with senescence.6 Eighty-five percent of proximal humeral fractures are minimally displaced or nondisplaced and can be effectively treated with early functional exercises. In the remaining 15 displaced proximal humeral fractures the knowledge and skill of the surgeon will in part determine the functional outcome. Knowledge of the bony architecture the effect of muscle action and the blood supply underlie successful classification and treatment of these injuries. Neer s classification and treatment scheme for displaced proximal humeral fractures1 has greatly facilitated rational management. Anatomy Bones The proximal humerus consists of four well-defined parts the humeral head the lesser and greater tuberosities and the proximal humeral shaft. There is a well-defined relationship between these four parts and the neck-shaft inclination angle which measures an average of 145 degrees in relation to the shaft and is