The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture.
- Author:
Chang Meen SUNG
1
;
Se Hyun CHO
;
Soon Taek JUNG
;
Sun Chul HWANG
;
Hyung Bin PARK
Author Information
1. Department of Orthopaedic Surgery, School of Medicine, Gyeongsang National University, Jinju, Korea. hbinpark@nongae.gsnu.ac.kr
- Publication Type:Original Article
- Keywords:
Proximal humerus;
Comminuted Fracture;
Hemiarthroplasty
- MeSH:
Aged;
Axillary Artery;
Brachial Plexus;
Classification;
Female;
Follow-Up Studies*;
Fractures, Comminuted;
Hemiarthroplasty*;
Humans;
Joints;
Male;
Rupture;
Shoulder;
Shoulder Fractures*
- From:Journal of the Korean Shoulder and Elbow Society
2007;10(1):92-98
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years (range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2(6~10), 6.6(2~8), and 6.9(4~8). The total UCLA score was an average of 21.7(12~26). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.
