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Reverse shoulder arthroplasty for four-part proximal humerus fracture in elderly patients: can a healed tuberosity improve the functional outcomes?

Authors
 Yong-Min Chun  ;  Doo-Sup Kim  ;  Doo-Hyung Lee  ;  Sang-Jin Shin 
Citation
 JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol.26(7) : 1216-1221, 2017 
Journal Title
JOURNAL OF SHOULDER AND ELBOW SURGERY
ISSN
 1058-2746 
Issue Date
2017
MeSH
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Shoulder/methods* ; Case-Control Studies ; Female ; Fractures, Comminuted/diagnostic imaging ; Fractures, Comminuted/surgery* ; Health Services for the Aged ; Humans ; Male ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Shoulder Fractures/diagnostic imaging ; Shoulder Fractures/surgery* ; Visual Analog Scale
Keywords
Proximal humerus ; arthroplasty ; fracture ; repair ; shoulder ; tuberosity
Abstract
BACKGROUND: The purpose of this study was to investigate whether healed tuberosities yield better rotational range of motion (ROM) and functional outcomes compared with unhealed tuberosities after reverse shoulder arthroplasty in elderly patients with comminuted proximal humerus fractures.

METHODS: This study included 38 patients who underwent reverse arthroplasty because of 4-part proximal humerus fractures; 14 patients had healed tuberosities (group A) and 24 patients had unhealed tuberosities (group B). Functional assessments included visual analog scale pain score, American Shoulder and Elbow Surgeons score, Constant score, and active ROM.

RESULTS: There were no significant differences in the patients' demographics between the 2 groups. At final follow-up, no significant differences were found between groups in visual analog scale score (group A, 1.4; group B, 1.6; P = .647), American Shoulder and Elbow Surgeons score (74.3 and 70.7; P = .231), and Constant score (67.9 and 63.9; P = .228) and ROM with forward flexion and internal rotation. However, in external rotation, there was a significant difference between groups (29° and 10° in external rotation with the elbow at the side [P < .001]; 25° and 7° in external rotation with shoulder abduction [P < .001]).

CONCLUSION: After reverse shoulder arthroplasty for 4-part proximal humerus fracture, tuberosities were healed in an anatomic position in 37% of patients. However, there were no significant differences in functional outcomes and ROM between the 2 groups, with the exception of external rotation, which was better in the healed tuberosity group. Therefore, tuberosity healing is not a prerequisite for satisfactory outcomes after reverse shoulder arthroplasty for 4-part proximal humerus fractures in elderly patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S1058274616306073
DOI
10.1016/j.jse.2016.11.034
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160272
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