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TREATMENT OF PROXIMAL HUMERAL FRACTURES USING BIARTICULAR ARTHROPLASTY



Abstract

Introduction and Objectives: Fractures of the proximal third of the humerus represent 4–5% of all fractures in our area. About 80–85% can be treated conservatively, though there is controversy over the best method treatment for complex fractures. The aim of our study is to analyse the results of treatment of these fractures by means of biarticular arthroplasty.

Materials and Methods: This is a retrospective study of 29 patients: 17 females and 12 males, with a mean age of 73.5 years, all of whom suffered complex fractures of the head of the humerus and were treated between the years 1995 and 2002. Minimum clinical follow-up time was 1 year. Patients were evaluated radiographically and clinically using the test of Constant, Swanson, and UCLA.

Results: One case developed a deep infection, which required removal of the arthroplasty and one case require replacement due to recurrent dislocation. Mean pain values measured on the RVA scale were 1.7 out of 10. Range of motion was limited compared to the contra-lateral shoulder. Mean Constant function index was 61.6 points, with a mean weighted Constant value of 90.8%.

Discussion and Conclusions: Biarticular prosthetic replacement offers good results in treatment of complex fractures of the proximal humerus, resulting in a shoulder that is non-painful though somewhat limited in strength and mobility. Best results are achieved in younger patients.

The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain