Schaft- und distale Humerusfrakturen.

Shaft fractures of the humerus are considered to be benign fractures and are still treated conservatively even today. Indications for operative procedures are open fractures, closed fracture types with severe soft tissue damage or complicated fractures which compromise muscles, blood vessels or nerves. Further indications for operative treatment are patients with multiple injuries including humeral shaft fractures. The standard techniques for stabilization of shaft fractures of the humerus are closed reduction with antegrade or retrograde nailing and open reduction and stabilization with locking or non-locking plates. The reasons for revision after operative treatment are radial nerve palsy and the development of pseudarthrosis. In 90 % of cases primary palsy of the radial nerve undergoes spontaneous remission without further operative treatment but secondary palsy of the radial nerve following surgery should be promptly treated. After conservative treatment pseudarthrosis occurs in 2-8 % and after operative treatment in 6-15 % of the cases. After open surgical resection of the pseudarthrosis and changing the type of osteosynthesis, stabilization should be completed with cancellous bone transplantation. Distal humeral fractures, often comminuted or complex fracture types, must be fixed by anatomical reconstruction and stabilization with 90° or 180° locking compression plates to stabilize the ulnar and radial axis of the elbow. The necessity of postoperative physiotherapy for the patient requires high stability of the osteosynthesis used. Even with the best radiological and anatomical results movement restrictions often remain after surgical treatment of the distal humerus; therefore, it should be borne in mind that a total elbow replacement is a primary option particularly for geriatric patients. [ABSTRACT FROM AUTHOR]