R Russo1, G Della Rotonda2, F Cautiero3, M Ciccarelli4,5. 1. Orthopedics and Traumatology Department, Pellegrini Hospital, Naples, Italy. raffrusso@tin.it. 2. Orthopedics and Traumatology Unit, Ruesch Clinic, Naples, Italy. peppedellarotonda@gmail.com. 3. Orthopedics and Traumatology Department, Pellegrini Hospital, Naples, Italy. fabiocau@inwind.it. 4. Orthopedics and Traumatology Department, Pellegrini Hospital, Naples, Italy. ciccarelli.michele@gmail.com. 5. , Via Scipione n. 6 lago patria, 80014, Giugliano in Campania, Naples, Italy. ciccarelli.michele@gmail.com.
Abstract
PURPOSE: The aim of this study is to report the clinical and radiological results of reverse total shoulder arthroplasty (rTSA) in elderly patients who have been treated for complex humeral fractures. MATERIALS AND METHODS: From January 2005 to December 2014, we have implanted rTSA for proximal humeral fractures in 95 patients (80 women, 15 men) about 75 years old on average (range 62-95 years). All rates and results on intraoperative and postoperative complications have been collected in a specific database. In all cases we have used a modular implant prosthesis (Lima Corporate, San Daniele del Friuli, Italy). The prosthesis was implanted cementless in 92 cases. Because of the presence of a high percentage of comorbidities in the elderly patients, we have retrospectively analyzed the necessity of a secondary hospitalization, from a week to a 6-month time after the discharge, due to general health problems and specific postoperative shoulder complications. The mean follow-up was 5 years (range 1-9 years) for 70 of 95 patients, 50 of whom had adequate radiographic controls. RESULTS: None of 95 patients has required a reoperation or a hospitalization for general health problems from 1 week to 6 months postoperative. No early or late infection of prosthesis has been observed. There were seven cases of perioperative complications, three humeral vertical bone fissuring, two glenoid fractures and two cases of deltoid muscle damage. We have had three cases of postoperative hematoma and one case of ulnar nerve neuropathy. The mean constant score was 85.4, and the mean simple shoulder test was 7.4. We have observed a grade 1 scapular notching in 15 cases (30 %). In the remaining 35 reviewed cases, there was no notching. Peri-articular heterotopic ossifications were found in 11 cases (22 %). CONCLUSION: Reverse shoulder prosthesis in complex humeral fractures in the elderly can be considered as a reliable surgical procedure, which leads to very good clinical and radiological results in case of cementless prosthesis, as well.
PURPOSE: The aim of this study is to report the clinical and radiological results of reverse total shoulder arthroplasty (rTSA) in elderly patients who have been treated for complex humeral fractures. MATERIALS AND METHODS: From January 2005 to December 2014, we have implanted rTSA for proximal humeral fractures in 95 patients (80 women, 15 men) about 75 years old on average (range 62-95 years). All rates and results on intraoperative and postoperative complications have been collected in a specific database. In all cases we have used a modular implant prosthesis (Lima Corporate, San Daniele del Friuli, Italy). The prosthesis was implanted cementless in 92 cases. Because of the presence of a high percentage of comorbidities in the elderly patients, we have retrospectively analyzed the necessity of a secondary hospitalization, from a week to a 6-month time after the discharge, due to general health problems and specific postoperative shoulder complications. The mean follow-up was 5 years (range 1-9 years) for 70 of 95 patients, 50 of whom had adequate radiographic controls. RESULTS: None of 95 patients has required a reoperation or a hospitalization for general health problems from 1 week to 6 months postoperative. No early or late infection of prosthesis has been observed. There were seven cases of perioperative complications, three humeral vertical bone fissuring, two glenoid fractures and two cases of deltoid muscle damage. We have had three cases of postoperative hematoma and one case of ulnar nerve neuropathy. The mean constant score was 85.4, and the mean simple shoulder test was 7.4. We have observed a grade 1 scapular notching in 15 cases (30 %). In the remaining 35 reviewed cases, there was no notching. Peri-articular heterotopic ossifications were found in 11 cases (22 %). CONCLUSION: Reverse shoulder prosthesis in complex humeral fractures in the elderly can be considered as a reliable surgical procedure, which leads to very good clinical and radiological results in case of cementless prosthesis, as well.
Entities:
Keywords:
Proximal humerus fracture; Reconstruction; Reverse total shoulder arthroplasty
Authors: Charles M Jobin; Balazs Galdi; Oke A Anakwenze; Christopher S Ahmad; William N Levine Journal: J Am Acad Orthop Surg Date: 2015-01-28 Impact factor: 3.020
Authors: Daniel Molé; Frank Wein; Charles Dézaly; Philippe Valenti; François Sirveaux Journal: Clin Orthop Relat Res Date: 2011-09 Impact factor: 4.176
Authors: Nicholas M Brown; Cara A Cipriano; Mario Moric; Scott M Sporer; Craig J Della Valle Journal: J Arthroplasty Date: 2011-05-08 Impact factor: 4.757
Authors: Pascal Boileau; Barbara Melis; David Duperron; Grégory Moineau; Adam P Rumian; Yung Han Journal: J Shoulder Elbow Surg Date: 2013-05-22 Impact factor: 3.019