Abstract
Purpose: Shoulder replacement becomes more indicated in complex fractures of the humeral head. Indications depend on some factors especially age and fracture’s pattern. The aim of our study is to compare the functional results of both reverse shoulder arthroplasty (RSA) and hemi-arthroplasty (HA) in complex proximal humerus fractures. Materials and Methods: Fifty-two shoulder arthroplasties (20 reverse shoulder arthroplasties, 38 hemiarthroplasties), were reviewed retrospectively, between January 2010, and December, 2015. Preoperative, operative, and postoperative evaluations were achieved based on medical observations. At last follow-up, functional outcomes were established according Constant-Murley Score and American Shoulder and Elbow Surgeons (ASES) score. Complications rates were well-defined and compared between the study groups. Results: The mean of follow-up was 41.5 months. Comparing the study groups, reverse shoulder arthrosplasties were significantly older (mean age: 76.3 versus 66). These fractures occur more in women (70% versus 57%). At last follow-up, functional outcomes were better in reverse shoulder arthroplasty group (Constant-Murley Score 76 versus 59; ASES score 56 versus 41). The mean anterior elevation and external rotation were better in reverse shoulder arthroplasty respectively (110°versus 88°; 28° versus 19°). Revision was more required in hemiarthroplasty group than reverse shoulder arthroplasty group. Conclusion: Reverse shoulder arthroplasty seems to improve functional outcome at intermediate and long-term of follow-up of proximal complex humeral fractures on comparison to hemiarthroplasty.
Highlights
Complex fractures of the proximal humerus become more frequent in daily practice, explained by the increasing rate of osteoporosis in actual aging populations [1]
We have reviewed retrospectively all cases of complex fractures of the humeral head treated with shoulder arthroplasty
Two groups had been established based on the type of arthroplasty indicated in each case
Summary
Complex fractures of the proximal humerus become more frequent in daily practice, explained by the increasing rate of osteoporosis in actual aging populations [1]. These injuries are considered to be the third fracture of person aged more than 65 year-old [2] [3]. Several series were found evaluating functional outcome after both hemiarthroplasty and reverse shoulder arthroplasty but with few comparative studies [8] [9] [10] [11]. The aim of our study was to compare the functional outcome of reverse versus hemiarthroplasty shoulder replacement in complex proximal humeral fractures
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