Shoulder arthroplasty for late sequelae of proximal humeral fractures

Twenty-eight patients with sequelae of proximal humeral fractures were treated with shoulder arthroplasty and were reviewed with a mean follow-up of 47 months. There were 8 malunions, 7 osteonecrosis, and 2 nonunions of the proximal humerus. Degenerative joint disease without any distortion of the t...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2004-05, Vol.13 (3), p.305-312
Main Authors: Mansat, Pierre, Guity, Mohamad R, Bellumore, Yves, Mansat, Michel
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis - etiology
Arthritis - surgery
Arthroplasty, Replacement - methods
Biological and medical sciences
Female
Humans
Male
Medical sciences
Middle Aged
Orthopedic surgery
Shoulder - surgery
Shoulder Fractures - complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
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Summary:Twenty-eight patients with sequelae of proximal humeral fractures were treated with shoulder arthroplasty and were reviewed with a mean follow-up of 47 months. There were 8 malunions, 7 osteonecrosis, and 2 nonunions of the proximal humerus. Degenerative joint disease without any distortion of the tuberosities had developed in 11. We performed 8 total shoulder arthroplasties and 20 hemiarthroplasties. On the basis of the Neer criteria, the results were satisfactory in only 64%. Fifteen patients had superior migration of the implant. One patient had to be reoperated on because of deep infection. The prognosis was influenced positively by the integrity of the rotator cuff at surgery, whereas the need for greater tuberosity osteotomy worsened the final result. The data suggest that malunion of the greater tuberosity can be tolerated if it does not compromise acceptable positioning of the humeral component. However, if there is a malunion of the greater tuberosity with major displacement, an osteotomy must be performed, with unpredictable results.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2004.01.020