Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 8/2010

01.12.2010 | Original Article

Shoulder arthroplasty as a treatment for sequelae of proximal humeral fractures

verfasst von: Amr M. Abdelhady

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 8/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Nonoperative treatment of displaced proximal humeral fractures is associated with numerous complications such as malunion, nonunion and avascular necrosis of the humeral head. Patients with such complications frequently have pain and loss of shoulder functions. The purpose of this study is to evaluate the long-term outcome of patients who underwent shoulder arthroplasty as treatment for the sequelae of proximal humeral fractures.

Methods

This study was conducted on 21 patients with complicated late proximal humeral fractures in the period between 2000 and 2006; the mean age was 59 years. Twelve patients had malunited proximal humeral fractures, 6 patients had nonunited fractures and 3 cases with humeral head osteonecrosis. Patients with complete rotator cuff tears were not included in this study. The interval between the original trauma and time of arthroplasty was 5.7 months. Shoulder hemiarthroplasty was done for 18 patients, and total arthroplasty for 3 patients.

Results

The mean follow-up period was 69 months. Results according to modified Neer’s score were 7 patients had excellent, 9 had satisfactory and 5 had unsatisfactory results. Complications were one patient with nonunited osteotomized greater tuberosity and another patient with postoperative impingement syndrome that necessitate open acromioplasty, both patients were considered unsatisfactory.

Conclusion

This study concluded that shoulder arthroplasty as a treatment of late sequelae of proximal humeral fractures can restore most of the patients’ normal daily activities.
Literatur
1.
Zurück zum Zitat Antuna SA, Sperling JW, Cofield RH (2008) Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five years follow-up. J Shoulder Elbow Surg 17:202–209CrossRefPubMed Antuna SA, Sperling JW, Cofield RH (2008) Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five years follow-up. J Shoulder Elbow Surg 17:202–209CrossRefPubMed
2.
Zurück zum Zitat Antuna SA, Sperling JW, Sa′nchez-Sotelo J, Cofield RH (2002) Shoulder arthroplasty for proximal humeral malunions: long-term results. J Shoulder Elbow Surg 11:122–129CrossRefPubMed Antuna SA, Sperling JW, Sa′nchez-Sotelo J, Cofield RH (2002) Shoulder arthroplasty for proximal humeral malunions: long-term results. J Shoulder Elbow Surg 11:122–129CrossRefPubMed
3.
Zurück zum Zitat Beredjiklian PK, Iannotti JP, Norris TR, Williams GW (1998) Operative treatment of malunion of a fracture of the proximal aspect of the humerus. J Bone Joint Surg Am 80:1484–1497PubMed Beredjiklian PK, Iannotti JP, Norris TR, Williams GW (1998) Operative treatment of malunion of a fracture of the proximal aspect of the humerus. J Bone Joint Surg Am 80:1484–1497PubMed
4.
Zurück zum Zitat Boileau P, Trojani C, Walch G, Krishnan S, Romeo A, Sinnerton R (2001) Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg 10:299–308CrossRefPubMed Boileau P, Trojani C, Walch G, Krishnan S, Romeo A, Sinnerton R (2001) Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg 10:299–308CrossRefPubMed
5.
Zurück zum Zitat Bosch U, Skutek M, Fremerey RW, Tscherne H (1998) Outcome after primary and secondary hemiarthroplasty in elderly patients with fractures of the proximal humerus. J Shoulder Elbow Surg 7:479–484CrossRefPubMed Bosch U, Skutek M, Fremerey RW, Tscherne H (1998) Outcome after primary and secondary hemiarthroplasty in elderly patients with fractures of the proximal humerus. J Shoulder Elbow Surg 7:479–484CrossRefPubMed
6.
Zurück zum Zitat Dines DM, Warren RF, Altchek DW, Moeckel B (1993) Posttraumatic changes of the proximal humerus: malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty. J Shoulder Elbow Surg 2:11–21CrossRef Dines DM, Warren RF, Altchek DW, Moeckel B (1993) Posttraumatic changes of the proximal humerus: malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty. J Shoulder Elbow Surg 2:11–21CrossRef
7.
Zurück zum Zitat Frisch LH, Sojbjerg JO, Sneppen O (1991) Shoulder arthroplasty in complex acute and chronic proximal humeral fractures. Orthopedics 9:949–954 Frisch LH, Sojbjerg JO, Sneppen O (1991) Shoulder arthroplasty in complex acute and chronic proximal humeral fractures. Orthopedics 9:949–954
8.
Zurück zum Zitat Iannotti JP, Sidor ML (1997) Malunions of the proximal humerus. In: Warner JP, Iannotti JP, Gerber C (eds) Complex and revision problems in shoulder surgery. Lippincott-Raven, Philadelphia, pp 245–264 Iannotti JP, Sidor ML (1997) Malunions of the proximal humerus. In: Warner JP, Iannotti JP, Gerber C (eds) Complex and revision problems in shoulder surgery. Lippincott-Raven, Philadelphia, pp 245–264
9.
Zurück zum Zitat Kontakis K, TosounidisT GalanakisI, Megas P (2008) Prosthetic replacement for proximal humeral Fractures. Injury Int. J. Care Injured 39:1345–1358 Kontakis K, TosounidisT GalanakisI, Megas P (2008) Prosthetic replacement for proximal humeral Fractures. Injury Int. J. Care Injured 39:1345–1358
10.
Zurück zum Zitat Mansat P, Guity MR, Bellumore Y, Mansat M (2004) Shoulder arthroplasty for late sequelae of proximal humeral fractures. J Shoulder Elbow Surg 13:305–312CrossRefPubMed Mansat P, Guity MR, Bellumore Y, Mansat M (2004) Shoulder arthroplasty for late sequelae of proximal humeral fractures. J Shoulder Elbow Surg 13:305–312CrossRefPubMed
11.
Zurück zum Zitat Neer CS II (1970) Displaced proximal humeral fractures. Part I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089PubMed Neer CS II (1970) Displaced proximal humeral fractures. Part I. Classification and evaluation. J Bone Joint Surg Am 52:1077–1089PubMed
12.
Zurück zum Zitat Neer CS II (1990) Glenohumeral arthroplasty. In: Neer CS II (ed) Shoulder reconstruction. Saunders, Philadelphia, pp 143–269 Neer CS II (1990) Glenohumeral arthroplasty. In: Neer CS II (ed) Shoulder reconstruction. Saunders, Philadelphia, pp 143–269
13.
Zurück zum Zitat Norris T, Green A, McGuigan F (1995) Late prosthetic shoulder arthroplasty for displaced proximal humerus fractures. J Shoulder Elbow Surg 4:271–280CrossRefPubMed Norris T, Green A, McGuigan F (1995) Late prosthetic shoulder arthroplasty for displaced proximal humerus fractures. J Shoulder Elbow Surg 4:271–280CrossRefPubMed
14.
Zurück zum Zitat Phipatanakul W, Jobe C (2008) Nonunion and malunion of the proximal humerus. In: Fealy S, Sperling J, Warren R, Craig E (eds) Shoulder arthroplasty. Thieme, New York, pp 67–71 Phipatanakul W, Jobe C (2008) Nonunion and malunion of the proximal humerus. In: Fealy S, Sperling J, Warren R, Craig E (eds) Shoulder arthroplasty. Thieme, New York, pp 67–71
15.
Zurück zum Zitat Sperling JW, Cofield RH, Rowland CM (1998) Neer hemiarthroplasty and Neer total shoulder arthroplasty in patients fifty years old or less. J Bone Joint Surg Am 80:464–473PubMed Sperling JW, Cofield RH, Rowland CM (1998) Neer hemiarthroplasty and Neer total shoulder arthroplasty in patients fifty years old or less. J Bone Joint Surg Am 80:464–473PubMed
16.
Zurück zum Zitat Wirth MA, Rockwood CA Jr (1994) Complications of shoulder arthroplasty. Clin Orthop 307:47–69PubMed Wirth MA, Rockwood CA Jr (1994) Complications of shoulder arthroplasty. Clin Orthop 307:47–69PubMed
Metadaten
Titel
Shoulder arthroplasty as a treatment for sequelae of proximal humeral fractures
verfasst von
Amr M. Abdelhady
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 8/2010
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-010-0630-8

Weitere Artikel der Ausgabe 8/2010

European Journal of Orthopaedic Surgery & Traumatology 8/2010 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.