scholarly journals Treatment of Complex Proximal Humeral Fractures in the Elderly with Reverse Shoulder Arthroplasty

2020 ◽  
Vol 12 (5) ◽  
pp. 1372-1379
Author(s):  
Xu Tian ◽  
Ming Xiang ◽  
Guangyu Wang ◽  
Bo Zhang ◽  
Junyang Liu ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Complex Proximal Humeral Fractures

scholarly journals Humeral Head Replacement and Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fracturesm

2017 ◽  
Vol 11 (1) ◽  
pp. 1108-1114 ◽  
Author(s):  
Aaron Andrew Frombach ◽  
Kendra Brett ◽  
Peter Lapner
Keyword(s):  
Shoulder Arthroplasty ◽  
New Technology ◽  
Reverse Shoulder Arthroplasty ◽  
Standard Of Care ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Current Evidence ◽  
Complication Rates ◽  
Surgical Fixation

Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain. While not conclusive, the evidence suggests that reverse shoulder arthroplasty yields more consistent results, with improved forward elevation and higher functional outcome scores. The primary advantages of hemiarthroplasty are improved shoulder rotation and shorter operative time. Complication rates do not vary significantly between the two options. Although higher quality trials are needed to further define the role of reverse shoulder arthroplasty, current evidence suggests that this is a reasonable option for surgeons who are highly familiar with its use.

scholarly journals Reverse Shoulder Arthroplasty for the Treatment of 3 and 4- Part Fractures of the Humeral Head in the Elderly

2017 ◽  
Vol 11 (1) ◽  
pp. 108-118 ◽  
Author(s):  
Ioannis Gigis ◽  
Alexandros Nenopoulos ◽  
Dimitrios Giannekas ◽  
Roderich Heikenfeld ◽  
Theodoros Beslikas ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Fracture ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Long Term Results ◽  
Cochrane Library ◽  
Osteoporotic Bone ◽  
Reverse Prosthesis

Background:Proximal humeral fractures in elderly patients present with severe comminution and osteoporotic bone quality.Reverse shoulder arthroplasty has lately been proven beneficial in treating patients with complex proximal humeral fractures. The above technique is recommended and has better results in elderly than in younger individuals.Methods:We performed a literature search in the databases Pubmed, Medline, EMBASE and Cochrane Library for published articles between 1970 and 2016 using the terms: proximal humerus fractures and reverse shoulder arthroplasty.Results:Significant benefits with the use of reverse prosthesis, especially in patients older than 70 years with a proximal humeral fracture, include reduced rehabilitation time as well as conservation of a fixed fulcrum for deltoid action in case of rotator cuff failure.Compared with hemiarthroplasty and internal fixation, reverse prosthesis may be particularly useful and give superior outcomes in older patients, due to comminuted fractures in osteopenic bones.However, significant disadvantages of this technique are potential complications and a demanding learning curve.Therefore, trained surgeons should follow specific indications when applying the particular treatment of proximal humeral fractures and be familiar with the surgical technique.Conclusion:Although long-term results and randomized studies for reverse prosthesis are lacking, short and mid- term outcomes have given promising results encouraging more shoulder surgeons to use this type of prosthesis in proximal humeral fractures.

scholarly journals Reverse Shoulder Arthroplasty Is Superior to Plate Fixation at 2 Years for Displaced Proximal Humeral Fractures in the Elderly

2020 ◽  
Vol 102 (6) ◽  
pp. 477-485 ◽  
Author(s):  
Alexander Nilsskog Fraser ◽  
Jonas Bjørdal ◽  
Tone Mehlum Wagle ◽  
Anna Cecilia Karlberg ◽  
Odd Arve Lien ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Plate Fixation ◽  
Reverse Shoulder Arthroplasty ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures

scholarly journals Reverse Total Shoulder Arthroplasty for Treatment of 3- and 4-Part Proximal Humeral Fractures: Clinical and Radiological Analysis With Minimum Follow-Up of 2 Years

2020 ◽  
Vol 11 ◽  
pp. 215145932091532
Author(s):  
Luis Barbosa ◽  
Luis Pires ◽  
Paulo Rego ◽  
Raul Alonso
Keyword(s):  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Complication Rates ◽  
The Mean ◽  
Complex Proximal Humeral Fractures

Background: Hemiarthroplasty has been associated with inferior and unpredictable outcomes when used in the treatment of complex proximal humeral fractures in elderly patients. In this age-group, reverse shoulder arthroplasty is gaining popularity due to the promising results presented in recent evidence. Our aim is to analyze the cases of complex proximal humeral fractures treated by reverse shoulder arthroplasty, regarding functional results and complications. Materials and Methods: Thirty-five fractures from 33 patients with the mean age of 73.5 (65-81) years were treated with reverse shoulder arthroplasty for complex fractures of the proximal humerus. These patients were followed for a mean of 38.3 months (24-68) and analyzed regarding clinical outcomes and complications. Results: The average Quick-Disabilities of the Arm, Shoulder and Hand and American Shoulder and Elbow Surgeons scores were 6.8 points and 78.3%, respectively. The mean Constant score on the affected side was 64.4 points, 19.5% less than the nonoperated side. The mean active elevation was 123°, abduction 109°, external rotation 38°, and internal rotation 41°. The radiographic tuberosity healing rate was 85.7%. There were no significant differences in outcomes, between patient with healed and reabsorbed tuberosities. Inferior scapular notching was seen in 8 patients. The global complication rate was 12.8%. Conclusion: Reverse shoulder arthroplasty yields good and reproductive results with acceptable complication rates in selected elderly patients with complex proximal humeral fractures.

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