Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 2/2020

01-04-2020 | Reverse Shoulder Arthroplasty (E Craig and C Chambers, Section Editors)

Reverse Shoulder Arthroplasty for Proximal Humerus Fracture

Authors: Brandon J. Kelly, Chad M. Myeroff

Published in: Current Reviews in Musculoskeletal Medicine | Issue 2/2020

Login to get access

Abstract

Purpose of Review

The purpose of this review is to examine trends, outcomes, and principles in treatment of proximal humerus fractures in the elderly with a critical focus on reverse shoulder arthroplasty as a developing treatment option.

Recent Findings

Recent literature shows an increase in reverse shoulder arthroplasty and a decrease in hemiarthroplasty performed for proximal humerus fractures. More predictable outcomes and lower revision rates are seen in older individuals treated primarily or secondarily with reverse shoulder arthroplasty compared to those treated with hemiarthroplasty.

Summary

We report current and historical treatments, outcomes, and principles in reverse shoulder arthroplasty for treatment of complex, displaced proximal humerus fractures in older individuals (≥ 65 years old).
Literature
1.
go back to reference Hasty EK, Jernigan EW, Soo A, Varkey DT, Kamath GV. Trends in surgical management and costs for operative treatment of proximal humerus fractures in the elderly. Orthopedics. 2017;40(4):641–7.CrossRef Hasty EK, Jernigan EW, Soo A, Varkey DT, Kamath GV. Trends in surgical management and costs for operative treatment of proximal humerus fractures in the elderly. Orthopedics. 2017;40(4):641–7.CrossRef
2.
go back to reference Bell J, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, et al. Humeral fractures in the elderly. J Bone Jt Surg. 2011;93-A(2):121–31.CrossRef Bell J, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, et al. Humeral fractures in the elderly. J Bone Jt Surg. 2011;93-A(2):121–31.CrossRef
3.
go back to reference Clement ND, Duckworth AD, Mcqueen MM. The outcome of proximal humeral fractures in the elderly predictors of mortality and function. Bone Jt J. 2014;96-B(7):970–7.CrossRef Clement ND, Duckworth AD, Mcqueen MM. The outcome of proximal humeral fractures in the elderly predictors of mortality and function. Bone Jt J. 2014;96-B(7):970–7.CrossRef
4.
go back to reference Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7.
6.
go back to reference Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res. 2012;64(3):407–14.CrossRef Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res. 2012;64(3):407–14.CrossRef
7.
go back to reference Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res. 2006;442:87–92.PubMedCrossRef Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res. 2006;442:87–92.PubMedCrossRef
8.
go back to reference Rajaee SS, Yalamanchilli D, Noori N, Debbi A, Mirocha J, Lin CA, et al. Increasing use of reverse total shoulder arthroplasty for proximal humerus fractures in elderly patients. Orthopedics. 2017;40(6):982–9.CrossRef Rajaee SS, Yalamanchilli D, Noori N, Debbi A, Mirocha J, Lin CA, et al. Increasing use of reverse total shoulder arthroplasty for proximal humerus fractures in elderly patients. Orthopedics. 2017;40(6):982–9.CrossRef
9.
go back to reference Schairer WW, Nwachukwu BU, Lyman S, Gulotta LV. Arthroplasty treatment of proximal humerus fractures: 14-year trends in the United States. Phys Sportsmed. 2017;45(2):92–6.PubMed Schairer WW, Nwachukwu BU, Lyman S, Gulotta LV. Arthroplasty treatment of proximal humerus fractures: 14-year trends in the United States. Phys Sportsmed. 2017;45(2):92–6.PubMed
11.
go back to reference Myeroff CM, Anderson JP, Sveom DS, Switzer JA. Predictors of mortality in elder patients with proximal humeral fracture. Geriatr Orthop Surg Rehabil. 2017;9:1–6. Myeroff CM, Anderson JP, Sveom DS, Switzer JA. Predictors of mortality in elder patients with proximal humeral fracture. Geriatr Orthop Surg Rehabil. 2017;9:1–6.
12.
go back to reference • Dillon MT, Prentice HA, Burfeind WE, Chan PH, Navarro RA. The increasing role of reverse total shoulder arthroplasty in the treatment of proximal humerus fractures. Injury. 2019;50(3):1–5. https://doi.org/10.1016/j.injury.2019.01.03Epidepmiological look at the increase in RSA and the decrease in hemiarthroplasty for proximal humerus fracture.CrossRef • Dillon MT, Prentice HA, Burfeind WE, Chan PH, Navarro RA. The increasing role of reverse total shoulder arthroplasty in the treatment of proximal humerus fractures. Injury. 2019;50(3):1–5. https://​doi.​org/​10.​1016/​j.​injury.​2019.​01.​03Epidepmiological look at the increase in RSA and the decrease in hemiarthroplasty for proximal humerus fracture.CrossRef
13.
go back to reference Kim SH, Wise BL, Zhang Y, Szabo RM. Increasing incidence of shoulder arthroplasty in the United States. J Bone Jt Surg - Ser A. 2011;93(24):2249–54.CrossRef Kim SH, Wise BL, Zhang Y, Szabo RM. Increasing incidence of shoulder arthroplasty in the United States. J Bone Jt Surg - Ser A. 2011;93(24):2249–54.CrossRef
16.
go back to reference Rasmussen S, Hvass I, Dalsgaard J, Christensen BS, Holstad E. Displaced proximal humeral fractures: results of conservative treatment. Injury. 1992;23(1):41–3.PubMedCrossRef Rasmussen S, Hvass I, Dalsgaard J, Christensen BS, Holstad E. Displaced proximal humeral fractures: results of conservative treatment. Injury. 1992;23(1):41–3.PubMedCrossRef
17.
go back to reference Zyto K. Non-operative treatment of the proximal humerus of comminuted fractures in elderly patients. Injury. 1998;29(5):349–52.PubMedCrossRef Zyto K. Non-operative treatment of the proximal humerus of comminuted fractures in elderly patients. Injury. 1998;29(5):349–52.PubMedCrossRef
18.
go back to reference Foruria AM, De Gracia MM, Larson DR, Munuera L, Sanchez-Sotelo J. The pattern of the fracture and displacement of the fragments predict the outcome in proximal humeral fractures. J Bone Jt Surg [Br]. 2005;93-B(3):378–86.CrossRef Foruria AM, De Gracia MM, Larson DR, Munuera L, Sanchez-Sotelo J. The pattern of the fracture and displacement of the fragments predict the outcome in proximal humeral fractures. J Bone Jt Surg [Br]. 2005;93-B(3):378–86.CrossRef
19.
go back to reference Court-Brown CM, Garg A, Mcqueen MM. The translated two-part fracture of the proximal humerus: epidemiology and outcome in the older patient. J Bone Jt Surg [Br]. 2001;83(6):799–804.CrossRef Court-Brown CM, Garg A, Mcqueen MM. The translated two-part fracture of the proximal humerus: epidemiology and outcome in the older patient. J Bone Jt Surg [Br]. 2001;83(6):799–804.CrossRef
20.
go back to reference Court-Brown CM, Cattermole H, Mcqueen MM. Impacted valgus fractures (B1.1) of the proximal humerus. Bone Jt J. 2002;84-B(4):504–8.CrossRef Court-Brown CM, Cattermole H, Mcqueen MM. Impacted valgus fractures (B1.1) of the proximal humerus. Bone Jt J. 2002;84-B(4):504–8.CrossRef
21.
go back to reference Iyengar JJ, Devcic Z, Sproul RC, Feeley BT. Nonoperative treatment of proximal humerus fractures: a systematic review. J Orthop Trauma. 2011;25(10):612–7.PubMedCrossRef Iyengar JJ, Devcic Z, Sproul RC, Feeley BT. Nonoperative treatment of proximal humerus fractures: a systematic review. J Orthop Trauma. 2011;25(10):612–7.PubMedCrossRef
22.
go back to reference Platzer P, Thalhammer G, Oberleitner G, Kutscha-lissberg F. Displaced fractures of the greater tuberosity: a comparison of operative and nonoperative treatment. J Trauma - Inj Infect Crit Care. 2004;65(4):843–8.CrossRef Platzer P, Thalhammer G, Oberleitner G, Kutscha-lissberg F. Displaced fractures of the greater tuberosity: a comparison of operative and nonoperative treatment. J Trauma - Inj Infect Crit Care. 2004;65(4):843–8.CrossRef
23.
go back to reference Rangan A, Handoll H, Brealey S, Jefferson L, Keding A, Martin BC, et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial. JAMA - J Am Med Assoc. 2015;313(10):1037–47.CrossRef Rangan A, Handoll H, Brealey S, Jefferson L, Keding A, Martin BC, et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial. JAMA - J Am Med Assoc. 2015;313(10):1037–47.CrossRef
24.
go back to reference •• Handoll HH, Keding A, Corbacho B, Brealey SD, Hewitt C, Rangan A, et al. Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus. J Bone Jt Surg [Br]. 2017;99-B(3):383–92 Follow-up to the PROFHER trial. While results are controversial due to significant selection bias, as discussed in the manuscript, the follow up of a large RCT still provides meaningful longer-term information on operatively vs. nonoperatively treated proximal humerus fractures.CrossRef •• Handoll HH, Keding A, Corbacho B, Brealey SD, Hewitt C, Rangan A, et al. Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus. J Bone Jt Surg [Br]. 2017;99-B(3):383–92 Follow-up to the PROFHER trial. While results are controversial due to significant selection bias, as discussed in the manuscript, the follow up of a large RCT still provides meaningful longer-term information on operatively vs. nonoperatively treated proximal humerus fractures.CrossRef
25.
go back to reference Brorson S. Management of fractures of the humerus in Ancient Egypt, Greece, and Rome. Clin Orthop Relat Res. 2009;467(7):1907–14.PubMedCrossRef Brorson S. Management of fractures of the humerus in Ancient Egypt, Greece, and Rome. Clin Orthop Relat Res. 2009;467(7):1907–14.PubMedCrossRef
26.
go back to reference Brorson S. Management of proximal humeral fractures in the nineteenth century. Clin Orthop Relat Res. 2011;469(4):1197–206.PubMedCrossRef Brorson S. Management of proximal humeral fractures in the nineteenth century. Clin Orthop Relat Res. 2011;469(4):1197–206.PubMedCrossRef
28.
go back to reference Neer CS. Articular replacement for the humeral head. J Bone Jt Surg. 1955;37-A:215–28.CrossRef Neer CS. Articular replacement for the humeral head. J Bone Jt Surg. 1955;37-A:215–28.CrossRef
29.
go back to reference Neer CS. Displaced proximal humeral fractures. Part 1. Classification and evaluation. J Bone Jt Surg. 1970;52-A:1077–89.CrossRef Neer CS. Displaced proximal humeral fractures. Part 1. Classification and evaluation. J Bone Jt Surg. 1970;52-A:1077–89.CrossRef
30.
go back to reference Neer CS. Displaced proximal humerus fractures. Part 2. Treatment of the three-part and four-part displacement. J Bone Jt Surg. 1970;52-A:1090–103.CrossRef Neer CS. Displaced proximal humerus fractures. Part 2. Treatment of the three-part and four-part displacement. J Bone Jt Surg. 1970;52-A:1090–103.CrossRef
31.
go back to reference Esser RD. Open reduction and internal fixation of three- and four-part fractures of the proximal humerus. Clin Orthop Relat Res. 1994;299:244–51. Esser RD. Open reduction and internal fixation of three- and four-part fractures of the proximal humerus. Clin Orthop Relat Res. 1994;299:244–51.
32.
go back to reference Moda SK, Chadha NS, Sangway SS, Khurana DK, Dahiya AS, Siwach RC. Open reduction and fixation of proximal humeral fractures and fractures-dislocations. J Bone Jt Surg [Br]. 1990;72-B:1050–2.CrossRef Moda SK, Chadha NS, Sangway SS, Khurana DK, Dahiya AS, Siwach RC. Open reduction and fixation of proximal humeral fractures and fractures-dislocations. J Bone Jt Surg [Br]. 1990;72-B:1050–2.CrossRef
33.
go back to reference Sehr JR, Szabo RM. Semitubular blade plate for fixation in the proximal humerus. J Orthop Trauma. 1989;2(4):327–32.CrossRef Sehr JR, Szabo RM. Semitubular blade plate for fixation in the proximal humerus. J Orthop Trauma. 1989;2(4):327–32.CrossRef
34.
go back to reference Zyto K, Ahrengart L, Sperber A, Tornkvist H. Treatment of displaced proximal humeral fractures in elderly patients. J Bone Jt Surg [Br]. 1997;79-B(3):412–7.CrossRef Zyto K, Ahrengart L, Sperber A, Tornkvist H. Treatment of displaced proximal humeral fractures in elderly patients. J Bone Jt Surg [Br]. 1997;79-B(3):412–7.CrossRef
35.
go back to reference Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, et al. Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma. 2009;23(3):163–72.PubMedCrossRef Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, et al. Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma. 2009;23(3):163–72.PubMedCrossRef
36.
go back to reference Charalambous CP, Siddique I, Valluripalli K, Kovacevic M, Panose P, Srinivasan M, et al. Proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures. Arch Orthop Trauma Surg. 2007;127:205–10.PubMedCrossRef Charalambous CP, Siddique I, Valluripalli K, Kovacevic M, Panose P, Srinivasan M, et al. Proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures. Arch Orthop Trauma Surg. 2007;127:205–10.PubMedCrossRef
37.
go back to reference Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 2005;430:176–81.CrossRef Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 2005;430:176–81.CrossRef
39.
go back to reference Koukakis A, Apostolou C, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop Relat Res. 2006;442:115–20.PubMedCrossRef Koukakis A, Apostolou C, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop Relat Res. 2006;442:115–20.PubMedCrossRef
41.
go back to reference Owsley KC, Gorczyca JT. Displacement/screw cutout after open reduction and locked plate fixation of humeral fractures. J Bone Jt Surg. 2008;90-A(2):233–40.CrossRef Owsley KC, Gorczyca JT. Displacement/screw cutout after open reduction and locked plate fixation of humeral fractures. J Bone Jt Surg. 2008;90-A(2):233–40.CrossRef
43.
go back to reference Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21(3):185–91.PubMedCrossRef Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21(3):185–91.PubMedCrossRef
44.
go back to reference Solberg BD, Moon CN, Franco DP, Paiement GD. Locked plating of 3-and 4-part proximal humerus fractures in older patients: the effect of initial fracture pattern on outcome. J Orthop Trauma. 2009;23(2):113–9.PubMedCrossRef Solberg BD, Moon CN, Franco DP, Paiement GD. Locked plating of 3-and 4-part proximal humerus fractures in older patients: the effect of initial fracture pattern on outcome. J Orthop Trauma. 2009;23(2):113–9.PubMedCrossRef
45.
go back to reference Namdari S, Lipman AJ, Ricchetti ET, Tjoumakaris FP, Russell Huffman G, Mehta S. Fixation strategies to prevent screw cut-out and malreduction in proximal humeral fracture fixation. Clin Orthop Surg. 2012;4(4):321–4.PubMedPubMedCentralCrossRef Namdari S, Lipman AJ, Ricchetti ET, Tjoumakaris FP, Russell Huffman G, Mehta S. Fixation strategies to prevent screw cut-out and malreduction in proximal humeral fracture fixation. Clin Orthop Surg. 2012;4(4):321–4.PubMedPubMedCentralCrossRef
46.
go back to reference Arvesen JE, Gill SW, Sinatra PM, Eng M, Bledsoe G, Kaar SG. Biomechanical contribution of tension-reducing rotator cuff sutures in 3-part proximal humerus fractures. J Orthop Trauma. 2016;30(8):e262–6.PubMedCrossRef Arvesen JE, Gill SW, Sinatra PM, Eng M, Bledsoe G, Kaar SG. Biomechanical contribution of tension-reducing rotator cuff sutures in 3-part proximal humerus fractures. J Orthop Trauma. 2016;30(8):e262–6.PubMedCrossRef
48.
go back to reference Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg. 2004;13(4):427–33.CrossRef Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg. 2004;13(4):427–33.CrossRef
50.
go back to reference Edelson G, Safuri H, Salami J, Vigder F, Militianu D. Natural history of complex fractures of the proximal humerus using a three-dimensional classification system. J Shoulder Elb Surg. 2008;17(3):399–409.CrossRef Edelson G, Safuri H, Salami J, Vigder F, Militianu D. Natural history of complex fractures of the proximal humerus using a three-dimensional classification system. J Shoulder Elb Surg. 2008;17(3):399–409.CrossRef
51.
go back to reference Zyto K, Wallace A, Frostick S, Preston B. Outcome after hemiarthroplasty for three- and four-part fractures of the proximal humerus. J Shoulder Elb Surg. 1998;7(2):85–9.CrossRef Zyto K, Wallace A, Frostick S, Preston B. Outcome after hemiarthroplasty for three- and four-part fractures of the proximal humerus. J Shoulder Elb Surg. 1998;7(2):85–9.CrossRef
52.
go back to reference Antuna SA, Sperling JW, Cofield RH, De Asturias P. Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five-year follow-up. J Shoulder Elb Surg. 2008;17(2):202–9.CrossRef Antuna SA, Sperling JW, Cofield RH, De Asturias P. Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five-year follow-up. J Shoulder Elb Surg. 2008;17(2):202–9.CrossRef
53.
go back to reference Boons HW, Goosen JH, Van Grinsven S, Van Susante JL, Van Loon CJ. Hemiarthroplasty for humeral four-part fractures for patients 65 years and older. Clin Orthop Relat Res. 2012;470(12):3483–91.PubMedPubMedCentralCrossRef Boons HW, Goosen JH, Van Grinsven S, Van Susante JL, Van Loon CJ. Hemiarthroplasty for humeral four-part fractures for patients 65 years and older. Clin Orthop Relat Res. 2012;470(12):3483–91.PubMedPubMedCentralCrossRef
54.
go back to reference Dimakopoulos P, Potamitis N, Lambiris E. Hemiarthroplasty in the treatment of comminuted intraarticular fractures of the proximal Hhumerus. Clin Orthop Relat Res. 1997;341:7–11.CrossRef Dimakopoulos P, Potamitis N, Lambiris E. Hemiarthroplasty in the treatment of comminuted intraarticular fractures of the proximal Hhumerus. Clin Orthop Relat Res. 1997;341:7–11.CrossRef
55.
go back to reference Sowa B, Thierjung H, Bülhoff M, Loew M, Zeifang F, Bruckner T, et al. Functional results of hemi- and total shoulder arthroplasty according to diagnosis and patient age at surgery. Acta Orthop. 2017;88(3):310–4.PubMedPubMedCentralCrossRef Sowa B, Thierjung H, Bülhoff M, Loew M, Zeifang F, Bruckner T, et al. Functional results of hemi- and total shoulder arthroplasty according to diagnosis and patient age at surgery. Acta Orthop. 2017;88(3):310–4.PubMedPubMedCentralCrossRef
56.
go back to reference Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Mole D. Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elb Surg. 2002;11(5):401–11.CrossRef Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Mole D. Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elb Surg. 2002;11(5):401–11.CrossRef
57.
go back to reference •• Hacket DJ, Hsu JE, Matsen FA. Primary shoulder hemiarthroplasty: what can be learned from 359 cases that were surgically revised. Clin Orthop Relat Res. 2018;476(5):1031–40 Hemiarthroplasty is technically challenging and few patients fit narrow indications.If any question of durability of rotator cuff or reconstructability of proximal humerus fracture RSA is viable option.CrossRef •• Hacket DJ, Hsu JE, Matsen FA. Primary shoulder hemiarthroplasty: what can be learned from 359 cases that were surgically revised. Clin Orthop Relat Res. 2018;476(5):1031–40 Hemiarthroplasty is technically challenging and few patients fit narrow indications.If any question of durability of rotator cuff or reconstructability of proximal humerus fracture RSA is viable option.CrossRef
59.
go back to reference Grubhofer F, Wieser K, Meyer DC, Catanzaro S, Beeler S, Rieder U, et al. Reverse total shoulder arthroplsty for acute head-splitting, 3- and 4-part fractures of the proximal humerus in the elderly. J Shoulder Elb Surg. 2016;25:1690–8.CrossRef Grubhofer F, Wieser K, Meyer DC, Catanzaro S, Beeler S, Rieder U, et al. Reverse total shoulder arthroplsty for acute head-splitting, 3- and 4-part fractures of the proximal humerus in the elderly. J Shoulder Elb Surg. 2016;25:1690–8.CrossRef
61.
go back to reference Shannon SF, Wagner ER, Houdek MT, Iii WWC, Sánchez-sotelo J. Reverse shoulder arthroplasty for proximal humeral fractures: outcomes comparing primary reverse arthroplasty for fracture versus reverse arthroplasty after failed osteosynthesis. J Shoulder Elb Surg. 2016;25(10):1655–60. Available from:. https://doi.org/10.1016/j.jse.2016.02.012.CrossRef Shannon SF, Wagner ER, Houdek MT, Iii WWC, Sánchez-sotelo J. Reverse shoulder arthroplasty for proximal humeral fractures: outcomes comparing primary reverse arthroplasty for fracture versus reverse arthroplasty after failed osteosynthesis. J Shoulder Elb Surg. 2016;25(10):1655–60. Available from:. https://​doi.​org/​10.​1016/​j.​jse.​2016.​02.​012.CrossRef
62.
go back to reference • Wolfensperger F, Grüninger P, Dietrich M, Völlink M, Benninger E, Schläppi M, et al. Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication. J Shoulder Elb Surg. 2017;26(8):1462–8. https://doi.org/10.1016/j.jse.2017.01.021Demonstrated high rate of return to independence following RSA for proximal humerus fracture within 1 year postoperatively.CrossRef • Wolfensperger F, Grüninger P, Dietrich M, Völlink M, Benninger E, Schläppi M, et al. Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication. J Shoulder Elb Surg. 2017;26(8):1462–8. https://​doi.​org/​10.​1016/​j.​jse.​2017.​01.​021Demonstrated high rate of return to independence following RSA for proximal humerus fracture within 1 year postoperatively.CrossRef
63.
go back to reference Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly. J Bone Jt Surg [Br]. 2007;89-B(4):516–20.CrossRef Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly. J Bone Jt Surg [Br]. 2007;89-B(4):516–20.CrossRef
64.
go back to reference Klein M, Juschka M, Hinkenjann B, Scherger B, Ostermann PAW. Treatment of comminuted fractures of the proximal humerus in elderly patients with the Delta III reverse shoulder prosthesis. J Orthop Trauma. 2008;22(10):698–704.PubMedCrossRef Klein M, Juschka M, Hinkenjann B, Scherger B, Ostermann PAW. Treatment of comminuted fractures of the proximal humerus in elderly patients with the Delta III reverse shoulder prosthesis. J Orthop Trauma. 2008;22(10):698–704.PubMedCrossRef
65.
go back to reference Lenarz C, Shishani Y, Mccrum C, Do RJN, Edwards TB, Gobezie R. Is reverse shoulder arthroplasty appropriate for the treatment of fractures in the older patient? Clin Orthop Relat Res. 2011;469(12):3324–31.PubMedPubMedCentralCrossRef Lenarz C, Shishani Y, Mccrum C, Do RJN, Edwards TB, Gobezie R. Is reverse shoulder arthroplasty appropriate for the treatment of fractures in the older patient? Clin Orthop Relat Res. 2011;469(12):3324–31.PubMedPubMedCentralCrossRef
67.
go back to reference •• Sebastia-Forcada E, Lizaur-Utrilla A, Cebrian-Gomez R, Miralles-Muñoz FA, Lopez-Prats FA. Outcomes of reverse total shoulder arthroplasty for proximal humeral fractures: primary arthroplasty versus secondary arthroplasty after failed proximal humeral locking plate fixation. J Orthop Trauma. 2017;31(8):236–40 Better postoperative functional scores, ROM, complication, and revision rate for primary vs. secondary RSA.CrossRef •• Sebastia-Forcada E, Lizaur-Utrilla A, Cebrian-Gomez R, Miralles-Muñoz FA, Lopez-Prats FA. Outcomes of reverse total shoulder arthroplasty for proximal humeral fractures: primary arthroplasty versus secondary arthroplasty after failed proximal humeral locking plate fixation. J Orthop Trauma. 2017;31(8):236–40 Better postoperative functional scores, ROM, complication, and revision rate for primary vs. secondary RSA.CrossRef
68.
go back to reference Seidl A, Sholder D, Warrender W, Livesey M, Jr GW, Abboud J, et al. Early versus late reverse shoulder arthroplasty for proximal humerus fractures: does it matter? Arch Bone Jt Surg. 2017;5(4):213–20.PubMedPubMedCentral Seidl A, Sholder D, Warrender W, Livesey M, Jr GW, Abboud J, et al. Early versus late reverse shoulder arthroplasty for proximal humerus fractures: does it matter? Arch Bone Jt Surg. 2017;5(4):213–20.PubMedPubMedCentral
69.
go back to reference •• Torchia MT, Austin DC, Cozzolino N, Jacobowitz L, Bell J. Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis. J Shoulder Elb Surg. 2019;28(4):765–73. https://doi.org/10.1016/j.jse.2018.10.004Meta-analysis and systematic review comparing acute versus delayed RSA demonstrating no significant outcome differences in timing.CrossRef •• Torchia MT, Austin DC, Cozzolino N, Jacobowitz L, Bell J. Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis. J Shoulder Elb Surg. 2019;28(4):765–73. https://​doi.​org/​10.​1016/​j.​jse.​2018.​10.​004Meta-analysis and systematic review comparing acute versus delayed RSA demonstrating no significant outcome differences in timing.CrossRef
70.
go back to reference •• Austin DC, Torchia MT, Cozzolino NH, Jacobowitz LE, Bell J. Decreased reoperations and improved outcomes with reverse total shoulder arthroplasty in comparison to hemiarthroplasty for geriatric proximal humerus fractures: a systematic review and meta-analysis. J Orthop Trauma. 2019;33(1):49–57 Meta-analysis and systematic review comparing RSA and hemiarthroplasty showed RSA significantly outperformed hemirathroplasty for proximal humerus fracture treatment.PubMedCrossRef •• Austin DC, Torchia MT, Cozzolino NH, Jacobowitz LE, Bell J. Decreased reoperations and improved outcomes with reverse total shoulder arthroplasty in comparison to hemiarthroplasty for geriatric proximal humerus fractures: a systematic review and meta-analysis. J Orthop Trauma. 2019;33(1):49–57 Meta-analysis and systematic review comparing RSA and hemiarthroplasty showed RSA significantly outperformed hemirathroplasty for proximal humerus fracture treatment.PubMedCrossRef
72.
go back to reference Ferrel JR, Trinh TQ, Fischer RA. Reverse total shoulder arthroplasty versus hemiarthroplasty for proximal humeral fractures: a systematic review. J Orthop Trauma. 2015;29(1):60–8.PubMedCrossRef Ferrel JR, Trinh TQ, Fischer RA. Reverse total shoulder arthroplasty versus hemiarthroplasty for proximal humeral fractures: a systematic review. J Orthop Trauma. 2015;29(1):60–8.PubMedCrossRef
73.
go back to reference •• Gallinet D, Ohl X, Decroocq L, Dib C, Valenti P, Boileau P, et al. Is reverse total shoulder arthroplasty more effective than hemiarthroplasty for treating displaced proximal humerus fractures in older adults? A systematic review and meta-analysis. Orthop Traumatol Surg Res. 2018;104(6):759–66. https://doi.org/10.1016/j.otsr.2018.04.025RSA patients had better clinical outcome scores and forward flexion postoperatively compared to hemiarthroplasty patients who had better internal and external rotation postoperatively.CrossRefPubMed •• Gallinet D, Ohl X, Decroocq L, Dib C, Valenti P, Boileau P, et al. Is reverse total shoulder arthroplasty more effective than hemiarthroplasty for treating displaced proximal humerus fractures in older adults? A systematic review and meta-analysis. Orthop Traumatol Surg Res. 2018;104(6):759–66. https://​doi.​org/​10.​1016/​j.​otsr.​2018.​04.​025RSA patients had better clinical outcome scores and forward flexion postoperatively compared to hemiarthroplasty patients who had better internal and external rotation postoperatively.CrossRefPubMed
74.
go back to reference Namdari S, Jg H, Baldwin K. Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures: a systematic review. J Bone Jt Surg. 2013;95-A(18):1701–8.CrossRef Namdari S, Jg H, Baldwin K. Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures: a systematic review. J Bone Jt Surg. 2013;95-A(18):1701–8.CrossRef
75.
go back to reference Bonnevialle N, Tournier C, Clavert P, Ohl X, Sirveaux F, Saragaglia D. Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: multicenter retrospective study. Orthop Traumatol Surg Res. 2016;102(2016):569–73.PubMedCrossRef Bonnevialle N, Tournier C, Clavert P, Ohl X, Sirveaux F, Saragaglia D. Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: multicenter retrospective study. Orthop Traumatol Surg Res. 2016;102(2016):569–73.PubMedCrossRef
78.
go back to reference Cuff DJ, Pupello DR. Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients. J Bone Jt Surg - Ser A. 2013;95(22):2050–5.CrossRef Cuff DJ, Pupello DR. Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients. J Bone Jt Surg - Ser A. 2013;95(22):2050–5.CrossRef
79.
go back to reference Garrigues GE, Johnston PS, Pepe MD, Tucker BS, Ramsey ML, Austin LS. Hemiarthroplasty versus reverse total shoulder arthroplasty for acute proximal humerus fractures in elderly patients. Orthopedics. 2012;35(5):703–8.CrossRef Garrigues GE, Johnston PS, Pepe MD, Tucker BS, Ramsey ML, Austin LS. Hemiarthroplasty versus reverse total shoulder arthroplasty for acute proximal humerus fractures in elderly patients. Orthopedics. 2012;35(5):703–8.CrossRef
81.
go back to reference • Reuther F, Petermann M, Stangl R. Reverse shoulder arthroplasty in acute fractures of the proximal humerus: does tuberosity healing improve clinical outcomes. J Orthop Trauma. 2019;33(2):46–51 Case series demonstrating no significant difference for functional scores or ROM for healed vs. unhealed greater tuberosity in RSA.CrossRef • Reuther F, Petermann M, Stangl R. Reverse shoulder arthroplasty in acute fractures of the proximal humerus: does tuberosity healing improve clinical outcomes. J Orthop Trauma. 2019;33(2):46–51 Case series demonstrating no significant difference for functional scores or ROM for healed vs. unhealed greater tuberosity in RSA.CrossRef
82.
go back to reference • Jain NP, Mannan SS, Dharmarajan R, Rangan A. Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients—does it improve outcomes? A systematic review and meta-analysis. J Shoulder Elb Surg. 2019;28(3):e78–91 Systematic review and meta-analysis showing RSA patients with healed greater tuberosity had better ROM and functional outcome scores.CrossRef • Jain NP, Mannan SS, Dharmarajan R, Rangan A. Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients—does it improve outcomes? A systematic review and meta-analysis. J Shoulder Elb Surg. 2019;28(3):e78–91 Systematic review and meta-analysis showing RSA patients with healed greater tuberosity had better ROM and functional outcome scores.CrossRef
83.
go back to reference • Simovitch RW, Roche CP, Jones RB, Routman HD, Marczuk Y, Wright TW, et al. Effect of tuberosity healing on clinical outcomes in elderly patients treated with a reverse shoulder arthroplasty for 3-and 4-part proximal humerus fractures. J Orthop Trauma. 2019;33(2):E39–45 Greater tuberosity healing in RSA results in better external rotation postoperatively than if it does not radiographically heal.PubMedCrossRef • Simovitch RW, Roche CP, Jones RB, Routman HD, Marczuk Y, Wright TW, et al. Effect of tuberosity healing on clinical outcomes in elderly patients treated with a reverse shoulder arthroplasty for 3-and 4-part proximal humerus fractures. J Orthop Trauma. 2019;33(2):E39–45 Greater tuberosity healing in RSA results in better external rotation postoperatively than if it does not radiographically heal.PubMedCrossRef
84.
go back to reference • Torrens C, Alentorn-geli E, Mingo F, Gamba C, Santana F. Reverse shoulder arthroplasty for the treatment of acute complex proximal humeral fractures: influence of greater tuberosity healing on the functional outcomes. J Orthop Surg. 2018;26(1):1–7 No significant differences among patients who undergo RSA and have tuberosity healing and those that do not.CrossRef • Torrens C, Alentorn-geli E, Mingo F, Gamba C, Santana F. Reverse shoulder arthroplasty for the treatment of acute complex proximal humeral fractures: influence of greater tuberosity healing on the functional outcomes. J Orthop Surg. 2018;26(1):1–7 No significant differences among patients who undergo RSA and have tuberosity healing and those that do not.CrossRef
86.
go back to reference Zhang AL, Schairer WW, Feeley BT. Hospital readmissions after surgical treatment of proximal humerus fractures: is arthroplasty safer than open reduction internal fixation? Clin Orthop Relat Res. 2014;472(8):2317–24.PubMedPubMedCentralCrossRef Zhang AL, Schairer WW, Feeley BT. Hospital readmissions after surgical treatment of proximal humerus fractures: is arthroplasty safer than open reduction internal fixation? Clin Orthop Relat Res. 2014;472(8):2317–24.PubMedPubMedCentralCrossRef
87.
go back to reference Gupta AK, Harris JD, Erickson BJ, Abrams GD, Bruce B, Mccormick F, et al. Surgical management of complex proximal humerus fractures — a systematic review of 92 studies including 4500 patients. J Orthop Trauma. 2015;29(1):54–9.PubMedCrossRef Gupta AK, Harris JD, Erickson BJ, Abrams GD, Bruce B, Mccormick F, et al. Surgical management of complex proximal humerus fractures — a systematic review of 92 studies including 4500 patients. J Orthop Trauma. 2015;29(1):54–9.PubMedCrossRef
88.
go back to reference • Gallinet D, Cazeneuve JF, Boyer E, Menu G, Obert L, Ohl X, et al. Reverse shoulder arthroplasty for recent proximal humerus fractures: outcomes in 422 cases. Orthop Traumatol Surg Res. 2019;1–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31279769. Revision rate for RSA after proximal humerus fracture is 5% after 238 months. • Gallinet D, Cazeneuve JF, Boyer E, Menu G, Obert L, Ohl X, et al. Reverse shoulder arthroplasty for recent proximal humerus fractures: outcomes in 422 cases. Orthop Traumatol Surg Res. 2019;1–7. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​31279769. Revision rate for RSA after proximal humerus fracture is 5% after 238 months.
89.
go back to reference • Klug A, Wincheringer D, Harth J, Schmidt-horloh K, Hoffmann R, Gramlich Y, et al. Complications after surgical treatment of proximal humerus fractures in the elderly--an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating. J Shoulder Elb Surg. 2019;1–11. RSA revision rate is 5.1%, which is lower than the 12.1% rate seen in ORIF patients with mean follow up 3.5 years. • Klug A, Wincheringer D, Harth J, Schmidt-horloh K, Hoffmann R, Gramlich Y, et al. Complications after surgical treatment of proximal humerus fractures in the elderly--an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating. J Shoulder Elb Surg. 2019;1–11. RSA revision rate is 5.1%, which is lower than the 12.1% rate seen in ORIF patients with mean follow up 3.5 years.
91.
go back to reference Neer CS. Four-segment classification of proximal humerus fractures: purpose and reliable use. J Shoulder Elb Surg. 2002;11(4):e389–400.CrossRef Neer CS. Four-segment classification of proximal humerus fractures: purpose and reliable use. J Shoulder Elb Surg. 2002;11(4):e389–400.CrossRef
94.
go back to reference Werner BC, Wong AC, Mahony GT, Craig EV, Dines DM, Warren RF, et al. Clinical outcomes after reverse shoulder arthroplasty with and without subscapularis repair: the importance of considering glenosphere lateralization. J Am Acad Orthop Surg. 2018;26(5):e114–9.PubMedCrossRef Werner BC, Wong AC, Mahony GT, Craig EV, Dines DM, Warren RF, et al. Clinical outcomes after reverse shoulder arthroplasty with and without subscapularis repair: the importance of considering glenosphere lateralization. J Am Acad Orthop Surg. 2018;26(5):e114–9.PubMedCrossRef
Metadata
Title
Reverse Shoulder Arthroplasty for Proximal Humerus Fracture
Authors
Brandon J. Kelly
Chad M. Myeroff
Publication date
01-04-2020
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 2/2020
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-020-09597-0

Other articles of this Issue 2/2020

Current Reviews in Musculoskeletal Medicine 2/2020 Go to the issue

Injuries in Overhead Athletes (J Dines and C Camp, Section Editors)

Step by Step Guide to Understanding the Kinetic Chain Concept in the Overhead Athlete

Pediatric Orthopedics (N Pandya, Section Editor)

Management of the Failed OCD

The Use of Technology in Orthopaedic Surgery—Intraoperative and Post-Operative Management (C Krueger and S Bini, Section Editors)

How New Technology Is Improving Physical Therapy

Reverse Shoulder Arthroplasty (E Craig and C Chambers, Section Editors)

Reverse Total Shoulder Arthroplasty: Technique, Decision-Making and Exposure Tips

Compressive Neuropathies in the Upper Extremity (E Shin, Section Editor)

Non-operative Treatment of Carpal Tunnel Syndrome