REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP

A. Abdelwahab; K. Yusuf; B. Singh

doi:10.1302/1358-992X.2022.11.021

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General Orthopaedics

REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP

The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Mansfield, England, 7–8 July 2022.

A. Abdelwahab
K. Yusuf
B. Singh

REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP

Abdelwahab A, Yusuf K, Singh B. REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP. Orthop Procs. 2022;104-B(SUPP_11):21-21. doi:10.1302/1358-992X.2022.11.021

Abdelwahab, A., et al. “REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_11, 2022, pp. 21-21., https://doi.org/10.1302/1358-992X.2022.11.021

Abdelwahab, A., Yusuf, K., & Singh, B. (2022). REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP. Orthopaedic Proceedings, 104-B(SUPP_11), 21-21. https://doi.org/10.1302/1358-992X.2022.11.021

Abdelwahab, A., Yusuf, K. and Singh, B. (2022) “REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP.” Orthopaedic Proceedings, 104-B(SUPP_11), pp. 21-21. Available at: https://doi.org/10.1302/1358-992X.2022.11.021

Abdelwahab, A., K. Yusuf, and B. Singh. “REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP.” Orthopaedic Proceedings 104-B, no. SUPP_11 (2022): 21-21. https://doi.org/10.1302/1358-992X.2022.11.021

Abdelwahab A, Yusuf K, Singh B. REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF THREE- AND FOUR-PART FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY: A PROSPECTIVE REVIEW OF 70 CASES WITH A MEDIUM-TERM FOLLOW-UP. Orthop Procs. 2022 Nov 1;104-B(SUPP_11):21-21. https://doi.org/10.1302/1358-992X.2022.11.021

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Abstract

Reverse shoulder arthroplasty (RSA) is being increasingly used for complex, displaced fractures of the proximal humerus. The main goal of the current study was to evaluate the functional and radiographic results after primary RSA of three or four-part fractures of the proximal humerus in elderly patients.

Between 2012 and 2020, 70 consecutive patients with a recent three- or four-part fracture of the proximal humerus were treated with an RSA. There were 41 women and 29 men, with a mean age of 76 years. The dominant arm was involved in 42 patients (60%). All surgeries were carried out within 21 days. Displaced three-part fracture sustained in 16 patients, 24 had fracture dislocation and 30 sustained a four-part fracture of the proximal humerus. Patients were followed up for a mean of 26 months.

The mean postoperative OSS at the end of the follow-up period was 32.4. The mean DASH score was 44.3. Tuberosity non-union occurred in 18 patients (12.6%), malunion in 7 patients (4.9%), heterotopic ossification in 4 patients (2.8%) and scapular notching in one patient. Anatomical reconstruction was achieved in 25 patients (17.5%), the influence of greater tuberosity healing on shoulder function could not be demonstrated. Heterotopic ossification seems to affect OSS and QDASH, we found statistically significant relation between HO and clinical outcomes. Patients with heterotopic ossification had significantly lower postoperative scores on DASH and OSS (P = .0527).

Despite expecting good functional outcome with low complication rate after RSA, the functional outcome was irrespective of healing of the tuberosities.