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Treatment of fracture sequelae of the proximal humerus: anatomical vs reverse shoulder prosthesis

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Abstract

The treatment of complex humeral fractures or fracture-dislocations presents several challenges. Late complications such as malunion, avascular necrosis, or nonunion are frequent and often lead to articular incongruence. Patients can be severely handicapped, presenting with considerable pain, stiffness, and important functional impairment. Stiff shoulders with distorted proximal humerus, soft tissue damage, a scarred deltoid, and rotator cuff tears make shoulder arthroplasty a challenging procedure, often with unpredictable results and a high risk of complications. The overall results of patients with old trauma are inferior to the results currently obtained in patients with primary osteoarthritis or with recent 4-part fractures who are treated initially with humeral head replacement. In certain circumstances, with important distortion of the proximal humerus, poor bone quality, rotator cuff lesions, or muscle atrophy a reverse shoulder arthroplasty can be proposed in elderly patients instead of a non-constrained arthroplasty.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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  1. Orthopedic and Traumatology Department, University Hospital of Toulouse, Hôpital Riquet, Chu Purpan, Place du Dr Baylac, 31059, Toulouse, France

    Pierre Mansat & Nicolas Bonnevialle

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  1. Pierre Mansat
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  2. Nicolas Bonnevialle
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Correspondence to Pierre Mansat.

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Mansat, P., Bonnevialle, N. Treatment of fracture sequelae of the proximal humerus: anatomical vs reverse shoulder prosthesis. International Orthopaedics (SICOT) 39, 349–354 (2015). https://doi.org/10.1007/s00264-014-2651-0

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  • DOI: https://doi.org/10.1007/s00264-014-2651-0

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