INTRODUCTION: Experience with treating proximal humeral nonunions with reverse total shoulder arthroplasty is limited. We report our results. PATIENTS: Eighteen patients with proximal humeral atrophic nonunion were treated with reverse total shoulder prosthesis. There were 12 women and 6 men, with a mean age of 78.8 years (range, 75-84 years). The mean follow up after reverse arthroplasty was 28 months (range, 24-32 months). Extensive proximal humeral bone loss that was found in six cases was treated adding a proximal humeral allograft. A long humeral stem was always used. RESULTS: The mean Constant score increased from 26% preoperatively to 55% postoperatively (p <0.0001). The average anterior elevation increased from 35° to 90° (p<0.0001), abduction from 35° to 85° (p<0.0001), external rotation from 15° to 30° (p <0.0001) and internal rotation from 25° to 55° (p <0.0001). The average subjective shoulder score increased from 10% preoperatively to 50% postoperatively (p <0.0001). All but 4 patients would undergo the same procedure again if faced with the same problem. Eight patients were very satisfied, 6 satisfied and 4 unhappy with the operation. We had one case of transitory axillary nerve palsy and two cases of infection. Two prosthetic dislocations occurred; they were successfully treated by revision with a larger polyethylene glenosphere of 44 mm. CONCLUSIONS: Reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the rate of dislocation is high.
INTRODUCTION: Experience with treating proximal humeral nonunions with reverse total shoulder arthroplasty is limited. We report our results. PATIENTS: Eighteen patients with proximal humeral atrophic nonunion were treated with reverse total shoulder prosthesis. There were 12 women and 6 men, with a mean age of 78.8 years (range, 75-84 years). The mean follow up after reverse arthroplasty was 28 months (range, 24-32 months). Extensive proximal humeral bone loss that was found in six cases was treated adding a proximal humeral allograft. A long humeral stem was always used. RESULTS: The mean Constant score increased from 26% preoperatively to 55% postoperatively (p <0.0001). The average anterior elevation increased from 35° to 90° (p<0.0001), abduction from 35° to 85° (p<0.0001), external rotation from 15° to 30° (p <0.0001) and internal rotation from 25° to 55° (p <0.0001). The average subjective shoulder score increased from 10% preoperatively to 50% postoperatively (p <0.0001). All but 4 patients would undergo the same procedure again if faced with the same problem. Eight patients were very satisfied, 6 satisfied and 4 unhappy with the operation. We had one case of transitory axillary nerve palsy and two cases of infection. Two prosthetic dislocations occurred; they were successfully treated by revision with a larger polyethylene glenosphere of 44 mm. CONCLUSIONS: Reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the rate of dislocation is high.
Authors: Till O Klatte; Reza Sabihi; Daniel Guenther; Atul F Kamath; Johannes M Rueger; Thorsten Gehrke; Daniel Kendoff Journal: HSS J Date: 2015-06-17
Authors: Stefan Quadlbauer; Georg J Hofmann; Martin Leixnering; Rudolf Rosenauer; Thomas Hausner; Jürgen Reichetseder Journal: Int Orthop Date: 2018-02-13 Impact factor: 3.075
Authors: Carlos Garcia-Fernandez; Yaiza Lopiz; Camilla Arvinius; Virginia Ponz; Borja Alcobía-Diaz; Pablo Checa; Maria Galán-Olleros; Fernando Marco Journal: Eur J Orthop Surg Traumatol Date: 2021-09-30