Hemiarthroplasty in Complex Proximal Humeral Fractures Is uncemented methaphyseal corundum blasted titanium humeral stem an efficent alternative?

Andrei Scripcaru,Elena Carmen Cotrutz,Cristinel Ionel Stan,Grigore Berea,Bogdan Puha

doi:10.37358/mp.18.4.5099

Abstract

The aim of this experimental study is to reveal the design and characteristics of unipolar shoulder prosthesis type Arrow (Groupe FH�, France) as well as to evaluate the outcome of the proximal humerus fracture treated with this implant. 8 patients with a mean age of 62.5 years were operated with immediate passive rehabilitation and active exercises initiated around day 45. All patients had good results with minimal pain, a mean Constant - Murley score of 74 and an acceptable shoulder amplitude. The clinical success was assured by the anatomic union of the tuberosities around the implant. The Arrow metaphyseal corundum blasted humeral titanium stem assures a perfect osseointegration with optimal stability and is an efficient alternative for shoulder hemiarthroplasty.

Highlights

Fractures of the proximal humerus in adults account for 4-5% of all fractures [1] and are the third most frequent fracture in the elderly following fractures of the proximal femur and distal radius [2,3]
While most simple fractures can be treated nonsurgicaly, prosthetic hemiarthroplasty has become an accepted method of treatment for some subgroups of proximal humerus fractures, including 4-parts fractures, 3-parts fractures in elderly patients with poor bone quality, fracture-dislocation, fractures of the anatomic neck and fractures affecting the joint surface of the humeral head which imply the destruction of over 50% of the humeral head [4,5]
In young patients motivated for a thorough post-operative rehabilitation, hemiarthroplasty is an alternative solution to osteosynthesis, especially in the case of high-energy trauma, where the risk of osteonecrosis is increased [10, 13]

Summary

Introduction

Fractures of the proximal humerus in adults account for 4-5% of all fractures [1] and are the third most frequent fracture in the elderly following fractures of the proximal femur and distal radius [2,3]. Despite the patient satisfaction after hemiarthroplasty with the pain - free shoulder, some restriction in active elevation [17,18,19], prompted the proposal of reversed total arthroplasty for the treatment of 3 -or 4 - parts fractures of the proximal humerus in elderly subject [20,21].

Results

Conclusion