{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T21:49:21Z","timestamp":1768513761848,"version":"3.49.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite implant improvement and increasing standardisation of operation techniques, the rate of therapy failure of proximal humeral fracture care with primary osteosyntheses is estimated to be 10 to 20%. Most commonly failure is precipitated by: material failure, technical error, non-anatomical repositioning, avascular necrosis, lacking medial support. An additive medial stabilisation of the so-called \u201ccalcar region\u201d can decrease failure rates significantly. An early correction osteosynthesis with the purpose of restoring the anatomy is indicated in bony, non-consolidated \u201cfresh\u201d fractures. Bony consolidated fractures should be classified according to Boileau and Walch. The authors of this article advice a structured and classification-adapted approach to treatment with a correction osteosynthesis. Post-traumatic deficits can be augmented utilising the following methods: correction osteosynthesis with allogeneic\/autologous bone grafts, correction osteosynthesis with\n\t\t\t\t\thydroxyapatite grafts. For the additive stabilisation of repositioned and fixated fractures, the following are described: correction osteosynthesis with an additive ventral one-third tubular plate, correction osteosynthesis with cement-augmented screws. Based on results of endoprosthetics following fractures of the proximal humerus, the correction osteosynthesis indeed represents a real therapeutic alternative in patients that are below the age of 60, a good bone mass and with relative functional requirements.<\/jats:p>","DOI":"10.1055\/a-0974-3887","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T22:53:12Z","timestamp":1571698392000},"page":"524-531","source":"Crossref","is-referenced-by-count":2,"title":["Corrective Osteosynthesis in Failed Proximal Humeral Fractures"],"prefix":"10.1055","volume":"158","author":[{"given":"Rony-Orijit","family":"Dey Hazra","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helmut","family":"Lill","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Ellwein","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Klinik der Medizinischen Hochschule Hannover (MHH), DIAKOVERE Annastift, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Warnhoff","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar","family":"Jensen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1016\/j.jse.2017.05.029","article-title":"Epidemiology of proximal humeral fractures: a detailed survey of 711 patients in a metropolitan area","volume":"26","author":"D Passaretti","year":"2017","journal-title":"J Shoulder Elbow Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s00113-014-2682-4","article-title":"Korrekturosteosynthesen proximaler Humerusfrakturen","volume":"118","author":"H Lill","year":"2015","journal-title":"Unfallchirurg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.otsr.2012.11.006","article-title":"Malunion of the proximal humerus","volume":"99 (1 Suppl.)","author":"F Duparc","year":"2013","journal-title":"Orthop Traumatol Surg Res"},{"key":"ref4","first-page":"148","article-title":"[Corrective interventions subsequent to humeral head fractures]","volume":"21","author":"P Habermeyer","year":"1992","journal-title":"Orthop\u00e4de"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s10195-017-0457-8","article-title":"Failure and revision rates of proximal humeral fracture treatment with the use of a standardized treatment algorithm at a level-1 trauma center","volume":"18","author":"J C Katthagen","year":"2017","journal-title":"J Orthop Traumatol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.jse.2010.10.040","article-title":"Medial support by fibula bone graft in angular stable plate fixation of proximal humeral fractures: an in vitro study with synthetic bone","volume":"20","author":"G Osterhoff","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1007\/s00264-011-1227-5","article-title":"The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study","volume":"35","author":"L Zhang","year":"2011","journal-title":"Int Orthop"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/BOT.0b013e31820beb80","article-title":"How does a varus deformity of the humeral head affect elevation forces and shoulder function? A biomechanical study with human shoulder specimens","volume":"25","author":"C Voigt","year":"2011","journal-title":"J Orthop Trauma"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/01.blo.0000195679.87258.6e","article-title":"Proximal humerus fracture sequelae: Impact of a new radiographic classification on arthroplasty","volume":"442","author":"P Boileau","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1067\/mse.2001.115985","article-title":"Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus","volume":"10","author":"P Boileau","year":"2001","journal-title":"J Shoulder Elbow Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"893","DOI":"10.2106\/JBJS.15.00506","article-title":"Reverse shoulder arthroplasty for malunions of the proximal part of the humerus (type-4 fracture sequelae)","volume":"98","author":"P Raiss","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1080\/17453674.2018.1450207","article-title":"High risk for revision after shoulder arthroplasty for failed osteosynthesis of proximal humeral fractures: a matched pair analysis of 285 cases from the Danish Shoulder Arthroplasty Registry","volume":"89","author":"M R Kristensen","year":"2018","journal-title":"Acta Orthop"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e236","DOI":"10.1097\/BOT.0000000000000858","article-title":"Outcomes of reverse total shoulder arthroplasty for proximal humeral fractures: primary arthroplasty versus secondary arthroplasty after failed proximal humeral locking plate fixation","volume":"31","author":"E Sebastia-Forcada","year":"2017","journal-title":"J Orthop Trauma"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1007\/s00113-015-0028-5","article-title":"Folgezust\u00e4nde nach proximaler Humerusfraktur","volume":"118","author":"R Meller","year":"2015","journal-title":"Unfallchirurg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S1058-2746(05)80001-1","article-title":"Nonunions of the surgical neck of the humerus: surgical treatment with an intramedullary bone peg, internal fixation, and cancellous bone grafting","volume":"5","author":"G Walch","year":"1996","journal-title":"J Shoulder Elbow Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.1016\/j.jse.2016.04.038","article-title":"Three-dimensional corrective osteotomies of complex malunited humeral fractures using patient-specific guides","volume":"25","author":"L Vlachopoulos","year":"2016","journal-title":"J Shoulder Elbow Surg"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0974-3887.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T22:37:23Z","timestamp":1601591843000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0974-3887"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,21]]},"references-count":16,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,10,1]]},"published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0974-3887","relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"value":"1864-6697","type":"print"},{"value":"1864-6743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,21]]}}}