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Gleichzeitig ist die operative Versorgung aufgrund komplexer werdender morphologischer Frakturmerkmale, vor dem Hintergrund der abnehmenden Knochenqualit\u00e4t, h\u00e4ufiger indiziert und anspruchsvoller durchzuf\u00fchren. Die osteosynthetische Versorgung mithilfe der winkelstabilen Plattenosteosynthese ist neben der inversen Frakturprothetik weiterhin die Haupts\u00e4ule der operativen Behandlung. Das Therapiekonzept ist individuell abh\u00e4ngig von den morphologischen Frakturcharakteristika, dem patientenspezifischen Risikoprofil und der Expertise des Operateurs. Bei j\u00fcngeren Patienten ist, wenn umsetzbar, ein osteosynthetisches Vorgehen zu pr\u00e4ferieren. In den letzten Jahren werden vermehrt Osteosynthesetechniken kombiniert, um einen Humeruskopferhalt und eine ausreichende Stabilit\u00e4t zu erreichen. Das Risiko f\u00fcr Komplikationen wie sekund\u00e4re Dislokation und Schrauben-Cut-out ist durch eine verbesserte Indikationsstellung und Operationstechnik deutlich gesunken. Die Doppelplattenosteosynthese bietet als eines dieser Kombinationsverfahren durch eine zus\u00e4tzliche von ventral aufgebrachte Platte vielversprechende M\u00f6glichkeiten bei komplexen Frakturen und hat sich zunehmend im klinischen Alltag etabliert. Zementaugmentation von Schrauben oder unterschiedliche Bone-Grafts sind zus\u00e4tzliche M\u00f6glichkeiten, winkelstabile Plattenosteosynthesen zu erg\u00e4nzen, damit auch bei osteoporotischem Knochen ein gutes Rekonstruktionsergebnis erzielt werden kann.<\/jats:p>","DOI":"10.1007\/s00113-025-01574-x","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T11:53:24Z","timestamp":1745495604000},"page":"501-507","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osteosynthese bei proximaler Humerusfraktur","Osteosynthesis for proximal humeral fractures"],"prefix":"10.1007","volume":"128","author":[{"given":"Karl J.","family":"Sander","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Su\u00dfiek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mats Jonas","family":"Wieth\u00f6lter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Raschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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