A new prosthetic design for proximal humeral fractures: reconstructing the glenohumeral unit

• Published in: Journal of shoulder and elbow surgery 2004-07, Vol.13 (4), p.373-380
• Main Authors: De Wilde, Lieven F, Berghs, Bart M, Beutler, Thomas, Ferguson, Stephen J, Verdonk, René C
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cadaver; Diseases of the osteoarticular system; Female; Humans; Humeral Fractures - surgery; Joint Prosthesis; Juxtaarticular diseases. Extraarticular rhumatism; Male; Medical sciences; Middle Aged; Prosthesis Design; Prosthesis Implantation - methods; Range of Motion, Articular; Reconstructive Surgical Procedures - methods; Shoulder Joint - injuries; Shoulder Joint - surgery; Suture Techniques
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2004.01.018

A new shoulder prosthesis design for proximal humeral fractures has been developed. The rim of the articular component of this prosthesis has several holes to which the bone-tendon junction of the rotator cuff is fixed, to allow an anatomic reconstruction of the glenohumeral unit. The strength of the tuberosity fixation to this prosthesis is investigated in a cadaveric study. Artificial 4-part fractures were created in 18 human, fresh-frozen, paired shoulder joints with intact rotator cuffs. Two methods of tuberosity fixation were used in a matched-pair fashion. In group I the tuberosities were sutured to the rim of the prosthetic head, and in group II the tuberosities were circumferentially tension band–wired. Strength testing was performed on a material-testing machine, and displacement was recorded with an opto-electronic device. Both fixation methods proved to be equally reliable in the forces exerted during activities of daily living without significant displacement of the fracture fragments.