Semi-shoulder arthroplasty in treatment of three or four part proximal humeral fractures in elderly

Abstract

Objective To analyze the methods and the outcome of the semi-shoulder arthroplasty in the treatment of three or four parts proximal humeral fractures in the elderly. Methods From Jan 2012 to Jan 2016, proximal humeral fractures whose undergone semi-shoulder arthroplasty were reviewed.The partⅢ or Ⅳproximal humeral fractures were included according to Neer classification and pathological fracture was excluded. Outcomes were evaluated by visual analogue scale (VAS), Constant-Murley scoring system and active range of motion of shoulder at eight, 12, 48 weeks postoperatively. One-way ANOVA was used for statistical analyzed. Results Twenty-seven patients were finally reviewed, which included 11 cases of part Ⅲfractures (four cases with shoulder dislocation) and 16 cases of partⅣ fractures, (12 cases with shoulder dislocation). All the patients were followed up for an average of (24.7±6.3) months. Mean VAS score was (1.3±0.7) and Constant-Murley score was (81.2±5.7) at the 48 weeks postoperatively. The average range of active movement of shoulder joint at the 48 weeks postoperativelywere as following: forward flexion (113±15) °, abduction (97±4) °, internal rotation (50±13) °, external rotation (39±12) ° and extension (41.7± 14.2) °. No postoperative complications occurred, such as nerve injury, heterotopic ossification and infection. Conclusions Hemiarthroplasty is an effective method for the treatment of the partⅢ or Ⅳof the proximal humeral fracture in the elderly. The accurate reconstruction of humerus length, effective restoration of shoulder cuff, correct reconstruction of the large and small nodules, combine with long-term and standardized rehabilitation training after operation are the keys to success in semi-shoulder arthroplasty. Key words: Shoulder fractures; Arthroplasty