Hemiarthroplasty versus reverse shoulder arthroplasty: comparative study of functional and radiological outcomes in the treatment of acute proximal humerus fracture
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To compare functional and radiographic results of reverse prosthesis versus hemiarthroplasty after complex displaced proximal humeral fractures in elderly patients when adequate ORIF cannot be achieved and prosthetic shoulder replacement is required.
From 2008 to 2012, 67 patients were treated with hemiarthroplasty or reverse arthroplasty. We evaluated 53 cases with an average follow-up of 27.5 months (range 12–64). Twenty-eight patients with an average age of 71.4 years were treated with a hemiarthroplasty and 25 patients with an average age of 77.3 years with a reverse prosthesis. All patients were assessed before and after surgery by Constant–ASES–DASH score, strength in abduction, ER1, ER2, and X-rays.
In hemiarthroplasty group, we observed a mean Constant score of 42.3 pt, ASES score 51.3 pt, and DASH score 46.1, with an average strength of 1.3 lb in abduction and of 3.7 lb in ER1 and 1.8 lb in ER2. In reverse arthroplasty group, we measured a mean Constant of 56.2 pt, ASES 69.3 pt, and DASH score 40.4, with an average strength of 4.3 lb in abduction and of 3.3 lb in ER1 and 3.2 lb in ER2. Radiographically, it is interesting to observe that greater tuberosity healing rate was 37 % in hemiarthroplasty group compared to 84 % in reverse arthroplasty group. About complications, the highest rate was recorded in the hemiarthroplasty group.
Reverse shoulder arthroplasty indication is steadily increasing in acute displaced proximal humeral fracture. Pain and articular movement results appear better than those with hemiarthroplasty. Our data are similar to the international literature.
KeywordsHemiarthroplasty Reverse shoulder arthroplasty humeral proximal fracture
Conflict of interest
P. Baudi, G. Campochiaro, F. Serafini, G. Gazzotti, G. Matino, C. Rovesta, F. Catani declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.
Human & Animal Studies
The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.
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