Treatment of fracture sequelae of the proximal humerus: anatomical vs reverse shoulder prosthesis.

Abstract:

:The treatment of complex humeral fractures or fracture-dislocations presents several challenges. Late complications such as malunion, avascular necrosis, or nonunion are frequent and often lead to articular incongruence. Patients can be severely handicapped, presenting with considerable pain, stiffness, and important functional impairment. Stiff shoulders with distorted proximal humerus, soft tissue damage, a scarred deltoid, and rotator cuff tears make shoulder arthroplasty a challenging procedure, often with unpredictable results and a high risk of complications. The overall results of patients with old trauma are inferior to the results currently obtained in patients with primary osteoarthritis or with recent 4-part fractures who are treated initially with humeral head replacement. In certain circumstances, with important distortion of the proximal humerus, poor bone quality, rotator cuff lesions, or muscle atrophy a reverse shoulder arthroplasty can be proposed in elderly patients instead of a non-constrained arthroplasty.

journal_name

Int Orthop

authors

Mansat P,Bonnevialle N

doi

10.1007/s00264-014-2651-0

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

349-54

issue

2

eissn

0341-2695

issn

1432-5195

journal_volume

39

pub_type

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