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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2011

01-12-2011 | Symposium: Fractures of the Shoulder Girdle

Is Reverse Shoulder Arthroplasty Appropriate for the Treatment of Fractures in the Older Patient?: Early Observations

Authors: Christopher Lenarz, MD, Yousef Shishani, MD, Christopher McCrum, Robert J. Nowinski, DO, T. Bradley Edwards, MD, Reuben Gobezie, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2011

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Abstract

Background

The treatment of comminuted proximal humerus fractures in older patients is challenging. Variable values of functional outcomes scores, ROMs, patient satisfaction, and bony healing have been reported with conventional techniques, including open reduction and internal fixation, percutaneous pinning, and hemiarthroplasty. Another alternative is reverse total shoulder arthroplasty, although it is unclear whether this provides better ROM or function.

Questions/purposes

We (1) evaluated ROM, pain level, and American Shoulder and Elbow Surgeons scores of patients who had a reverse total shoulder arthroplasty for displaced three- and four-part proximal humerus fracture and (2) identified clinical and radiographic complications from the procedure.

Patients and Methods

We retrospectively reviewed 30 patients in three institutions who had undergone a primary reverse total shoulder arthroplasty for displaced three- or four-part proximal humerus fractures. Mean age was 77 years (range, 65–94 years). Minimum followup was 12 months (mean, 23 months; range, 12–36 months).

Results

Mean postoperative American Shoulder and Elbow Surgeons score was 78 (range, 36–98), mean active forward flexion was 139° (range, 90°–180°), and mean active external rotation was 27° (range, 0°–45°). Mean American Shoulder and Elbow Surgeons pain score was 0.7 (range, 0–5) and mean visual analog scale pain score was 1.1 (range, 0–5). Complications were identified in three of 30 patients (10%).

Conclusions

At short term, reverse total shoulder arthroplasty relieved pain and improved function. The complication rate compared favorably with those reported for other treatment alternatives.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Is Reverse Shoulder Arthroplasty Appropriate for the Treatment of Fractures in the Older Patient?: Early Observations
Authors
Christopher Lenarz, MD
Yousef Shishani, MD
Christopher McCrum
Robert J. Nowinski, DO
T. Bradley Edwards, MD
Reuben Gobezie, MD
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-2055-z

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