Functional Outcome Following Reverse Total Shoulder Replacement in the Setting of Trauma with Minimum 1 Year Follow-Up

Tony Farrell,Muiris Kennedy,Ciaran Mcdonald,John Lunn

doi:10.4236/ojo.2018.87032

Abstract

Aims: To evaluate the short term functional outcomes following a reverse total shoulder replacement for complex neck of humerus fractures. Methods: A single centre retrospective case series evaluating all patients who underwent reverse shoulder arthroplasty following a complex neck of humerus fracture. Functional shoulder movements were assessed by two orthopaedic trainees at 1 year follow-up and compared to the opposite shoulder. Subjective assessment was measured using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Oxford Shoulder Score (OSS). Documentation of any complications was also noted. Findings: The reverse total shoulder replacement showed favourable outcomes both subjectively and objectively. Subjectively patients in this study scored a mean of 27.5 +/- 24.4 (range 0 - 57.8) in the DASH and 37.9 +/- 9.2 (range 26 - 48) in the OSS. There was a high negative linear correlation between the 2 scoring systems (r = -0.95, p Conclusion: A reverse total shoulder replacement shows favourable subjective and objective outcomes for complex neck of humerus fractures in the trauma setting.

Highlights

Humerus fracture is a common injury in the older person accounting for 4% 5% of all fractures [1]
Extension and abduction movements were similar in all patients between the injured and the uninjured limb with statistically significant differences noted in all movements
Humerus fractures are a common injury in the older person accounting for 4% 5% of all fractures

Summary

Introduction

Humerus fracture is a common injury in the older person accounting for 4% 5% of all fractures [1]. The proximal humerus is often fractured in patients with osteoporosis and is the third most common osteoporotic fracture type observed in elderly patients, after wrist and hip fractures [4] This would largely explain why the incidence between females and males is 3:1 with an exponential increase in incidence as patients become older [2] [3] [4]. An expanding elderly population will inevitably increase the number of proximal humerus fractures and ED visits with subsequent referrals to orthopaedic services [2]. This case series aims to build the evidence for a reverse shoulder arthroplasty in the setting of trauma as a means of fixating complex proximal humerus fractures

Results

Discussion

Conclusion