Abstract
Purpose
The aim of this paper was to present our experience and the outcomes in 3 elderly patients who underwent combined shoulder and elbow arthroplasty after ipsilateral fractures of the proximal and distal humerus in our center. Also, we evaluate difficulties in their treatment and report their final follow-up.
Material and methods
Three cases of elderly patients who underwent shoulder and elbow arthroplasty after ipsilateral fractures of the proximal and distal humerus were reviewed. Demographic, clinical, and radiological data were analyzed. Also, Constant Shoulder Score, Mayo Elbow Performance Score, Short-Form Health Survey, and four-point Likert scale were evaluated.
Results
All patients were females (100%). Mean age was 75 years (range 73–78). Mean follow-up was 36.6 months (SD 11.5). Mean time between injury and surgery was 12 days (SD 7.6). The 3 patients had a displaced and comminuted fracture of the humeral head (4-part, by Neer classification) and a comminuted intraarticular fracture of the distal humerus (13-C3, by AO classification). One patient presented a wound infection that required debridement. Despite the complications, at final follow-up, all patients showed a sufficient capacity to perform comfortably in their daily activities. Radiographs showed good fixation of all components, without evidence of prosthetic loosening or migration. All evaluated scores had good or excellent results.
Conclusions
Our study provides further evidence that the shoulder and elbow arthroplasty could be a reliable management for ipsilateral fractures of the proximal and distal humerus in the elderly. In our study, this technique showed in the final follow-up patient’s good outcomes.
Access this article
We’re sorry, something doesn't seem to be working properly.
Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.
Similar content being viewed by others
References
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R, Foundation NO (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381. https://doi.org/10.1007/s00198-014-2794-2
Giannoudis P, Tzioupis C, Almalki T, Buckley R (2007) Fracture healing in osteoporotic fractures: is it really different? A basic science perspective. Injury 38:90–99. https://doi.org/10.1016/j.injury.2007.02.014
Han RJ, Sing DC, Feeley BT, Ma CB, Zhang AL (2016) Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population. J Shoulder Elb Surg 25:256–261. https://doi.org/10.1016/j.jse.2015.07.015
Lami D, Chivot M, Caubere A, Galland A, Argenson JN (2017) First-line management of distal humerus fracture by total elbow arthroplasty in geriatric traumatology: results in a 21-patient series at a minimum 2 years’ follow-up. Orthop Traumatol Surg Res 103:891–897. https://doi.org/10.1016/j.otsr.2017.06.009
Vrettos BC, Neumann L, MacKie A, Damrel D, Wallace WA (2005) One-stage arthroplasty of the ipsilateral shoulder and elbow. J Shoulder Elb Surg 14:425–428. https://doi.org/10.1016/j.jse.2004.11.004
Rozing PM, Nagels J (2008) Shoulder and elbow arthroplasty: One-stage or Two-stage. J Shoulder Elb Surg 17:9–13. https://doi.org/10.1016/j.jse.2007.03.033
Chalidis B, Papadopoulos P, Sachinis N, Dimitriou C (2008) One-stage shoulder and elbow arthroplasty after ipsilateral fractures of the proximal and distal humerus. J Orthop Trauma 22:282–285. https://doi.org/10.1097/BOT.0b013e3181629a18
Horneff JG, Huffman GR (2013) Concurrent ipsilateral total elbow arthroplasty and reverse total shoulder arthroplasty: a case report and review of the literature. Univ Penn Orthop J 23:36–39
Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M et al (2018) Forecasting life expectancy, years of life lost, all-cause and cause-specific mortality for 250 causes of death : reference and alternative scenarios 2016–2040 for 195 countries and territories. Lancet 392:2052–2090. https://doi.org/10.1016/S0140-6736(18)31694-5
Cvetanovich GL, Frank RM, Chalmers PN, Verma NN, Nicholson GP, Romeo AA (2016) Surgical management of proximal humeral fractures: the emerging role of reverse total shoulder arthroplasty. Orthopedics 39:465–473. https://doi.org/10.3928/01477447-20160324-02
Sebastiá-Forcada E, Cebrián-Gómez R, Lizaur-Utrilla A, Gil-Guillén V (2014) Reverse shoulder arthroplasty versus hemiarthroplasty for acute proximal humeral fractures. A blinded, randomized, controlled, prospective study. J Shoulder Elb Surg 23:1419–1426. https://doi.org/10.1016/j.jse.2014.06.035
Shukla DR, McAnany S, Kim J, Overley S, Parsons BO (2016) Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elb Surg 25:330–340. https://doi.org/10.1016/j.jse.2015.08.030
Zalavras CG, Papasoulis E (2018) Intra-articular fractures of the distal humerus—a review of the current practice. Int Orthop 42:2653–2662. https://doi.org/10.1007/s00264-017-3719-4
Anthony CA, Duchman KR, Bedard N, Gholson JJ, Gao Y, Pugely AJ, Callaghan JJ (2017) Hip fractures: appropriate timing to operative intervention. J Arthroplasty 32:3314–3318. https://doi.org/10.1016/j.arth.2017.07.023
Abdelhady AM (2013) Timing of shoulder arthroplasty in comminuted proximal humerus fracture, how much does it matter? Eur J Orthop Surg Traumatol 23:515–519. https://doi.org/10.1007/s00590-012-1025-9
Menendez ME, Ring D (2014) Does the timing of surgery for proximal humeral fracture affect inpatient outcomes ? J Shoulder Elb Surg 23:1257–1262. https://doi.org/10.1016/j.jse.2014.03.010
Everhart JS, Bishop JY, Barlow JD (2017) Medical comorbidities and perioperative allogeneic red blood cell transfusion are risk factors for surgical site infection after shoulder arthroplasty. J Shoulder Elb Surg 26:1922–1930. https://doi.org/10.1016/j.jse.2017.04.006
Gill DR, Cofield RH, Morrey BF (1999) Ipsilateral total shoulder and elbow arthroplasties in patients who have rheumatoid arthritis. J Bone Joint Surg Am 81:1128–1137. https://doi.org/10.2106/00004623-199908000-00008
Plausinis D, Greaves C, Regan WD, Oxland TR (2005) Ipsilateral shoulder and elbow replacements: on the risk of periprosthetic fracture. Clin Biomech (Bristol, Avon) 20:1055–1063. https://doi.org/10.1016/j.clinbiomech.2005.06.012
Inglis AE, Inglis AE Jr (2000) Ipsilateral total shoulder arthroplasty and total elbow replacement arthroplasty: a caveat. J Arthroplasty 15:123–125
Keener JD, Chalmers PN, Yamaguchi K (2017) The humeral implant in shoulder arthroplasty. J Am Acad Orthop Surg 25:427–438. https://doi.org/10.5435/JAAOS-D-15-00682
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
JH. Nuñez, M. Garcia-Portabella, L. Batalla and J. Massons declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Nuñez, J.H., Garcia-Portabella, M., Batalla, L. et al. Shoulder and elbow arthroplasty after ipsilateral fractures of the proximal and distal humerus in the elderly. Eur J Orthop Surg Traumatol 30, 659–664 (2020). https://doi.org/10.1007/s00590-019-02608-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-019-02608-y