PDF(Pubmed)
Abstract：
The humeral head is considered the second most common site for osteonecrosis to occur after the femoral head. As seen in the femoral head, the circulatory implications characteristic of this condition are attributable to the interaction between a genetic predisposition and the exposure to certain risk factors. There is no consensus regarding the pathogenesis of osteonecrosis, yet the final common pathway results in disrupted blood supply, increased intraosseous pressure, and bone death. Disease staging using radiography and magnetic resonance imaging is predictive of disease progression and can help the orthopedic surgeon to guide treatment. Although there is a myriad of treatment modalities, there is a lack of high-quality evidence to conclude what is the most appropriate treatment option for each stage of humeral head osteonecrosis. Nonoperative treatment is the preferred option in early-stage disease, and it may prevent disease progression. Nonetheless, in some cases, disease progression occurs despite nonoperative measures, and surgical treatment is required. The purpose of this article is to provide an updated review of the available evidence on risk factors, diagnosis, and treatment of atraumatic humeral head osteonecrosis.
摘要：
肱骨头被认为是仅次于股骨头的第二大最常见的骨坏死部位。如在股骨头中看到的，这种情况的循环影响特征可归因于遗传易感性与暴露于某些危险因素之间的相互作用。关于骨坏死的发病机制尚无共识，然而，最终的共同途径导致血液供应中断，骨内压力增加，骨头死亡。使用射线照相术和磁共振成像进行疾病分期可以预测疾病进展，并可以帮助整形外科医生指导治疗。虽然有无数的治疗方式，目前缺乏高质量的证据来确定肱骨头骨坏死各阶段最适合的治疗方案.非手术治疗是早期疾病的首选，它可以防止疾病进展。尽管如此，在某些情况下,尽管采取了非手术措施，但仍发生疾病进展，需要手术治疗。本文的目的是提供有关风险因素的可用证据的最新审查，诊断,非创伤性肱骨头骨坏死的治疗。
