Prijelomi gornjeg dijela nadlaktične kosti

master's thesis

• Title (english): Fractures of proximal humerus
• Author: Vlatka Lehkec
• Mentor: Ivan Dobrić (mentor)
• Committee member: Tomislav Luetić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Ivan Dobrić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Cilj ovog rada je sažeti trenutna znanja o incidenciji, klasifikaciji i optimalnim metodama liječenja prijeloma gornjeg dijela nadlaktične kosti (humerus). Prijelomi gornje trećine humerusa čine oko 5% svih prijeloma kostiju, a najčešće se događaju u populaciji starijih od 45 godina. Kod žena su ovakvi prijelomi više nego dva puta češći u odnosu na muškarce i to se pripisuje većoj učestalosti osteoporoze u ženskoj populaciji starije dobi. Govoreći o prijelomima, gornji dio nadlaktične kosti dijelimo na četiri velika fragmenta: proksimalno od anatomskog vrata (collum anatomicum) je glava nadlaktične kosti (caput humeri), između anatomskog i kirurškog vrata (collum chirurgicum) nalaze se mali i veliki tuberkul (tuberculum minus et majus), a ispod kirurškog vrata počinje dijafiza kosti. Kod prijeloma moramo imati na umu mogućnost nastanka avaskularne nekroze glave humerusa(AVN) posljedično prekidu krvne opskrbe, slično kao kod prijeloma bedrene kosti (os femoris). Postavljanje dijagnoze ne predstavlja problem jer se, uz anamnestičke podatke i prisutne kliničke znakove, prijelom može dokazati kliničkim pregledom i rendgenskim snimkama. Odluka o liječenju je već teža, a glavna dilema je treba li se liječiti konzervativno ili operacijski.

Abstract (english)

This paper's objective is to summarize current knowledge about incidence, classification and optimal treatment methods for fractures of the proximal humerus. About 5% of all bone fractures are fractures of the proximal humerus. They most frequently occur in the population over 45 years old. These kind of fractures are more than two times more common in women, attributable to osteoporosis in elderly females. When talking about fractures, we can distinguish four major bone fragments: the humeral head is the portion of the humerus superior to the anatomical neck, the lesser tuberosity and greater tuberosity are two fragments placed between the anatomical and surgical neck of the humerus, and the fourth fragment is the shaft of the humerus. We have to be aware of the threat of avascular necrosis of the humeral head as a result of a cutoff blood supply, similar to femoral head necrosis in the case of some femoral fractures. Making the diagnose is not a problem, the fracture is established by clinical examination and shoulder x-rays in addition to patient history and present clinical features. The treatment decision is harder, with the main dilemma whether to choose nonoperative or operative treatment.

• Keywords: prijelom; humerus; liječenje; avaskularna nekroza
• Keywords (english): fracture; humerus; treatment; avascular necrosis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:166426
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-01-31 09:38:20