Clinical outcomes of reverse shoulder arthroplasty for the treatment of failed fixation of proximal humeral fracrtures in the elderly patients.
10.12200/j.issn.1003-0034.2023.02.003
- Author:
Wei-Bin DU
1
;
Yi DONG
2
;
Fu-Xiang SHEN
1
;
Rong-Liang CHEN
1
;
Shang-Ju XIE
1
;
Keng YU
1
;
Guo-Ping CAO
1
Author Information
1. Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China.
2. Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine, Shaoxing 311200, Zhejiang, China.
- Publication Type:Journal Article
- Keywords:
Elderly patient;
Proximal humeral fractures;
Reverse total shoulder arthroplasty;
Revision procedure
- MeSH:
Male;
Female;
Humans;
Aged;
Shoulder/surgery*;
Arthroplasty, Replacement, Shoulder/methods*;
Retrospective Studies;
Treatment Outcome;
Quality of Life;
Shoulder Joint/surgery*;
Shoulder Fractures/surgery*;
Humerus/surgery*;
Range of Motion, Articular
- From:
China Journal of Orthopaedics and Traumatology
2023;36(2):110-115
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the clinical outcomes of reverse total shoulder arthroplasty as a revision procedure for the failed fixation of proximal humeral fractures in the elderly patients.
METHODS:A retrospective analysis was performed on 8 patients with failed internal fixation of proximal humeral fractures from May 2014 to March 2020, including 3 males and 5 females, aged from 65 to 75 years old. All 8 patients underwent reverse total shoulder arthroplasty, and the mean time between initial fixation and reverse total shoulder arthroplasty ranged from 8 to 16 months. Range of motion(ROM), University of California at Los Angeles(UCLA) shoulder score, visual analogue scale (VAS), self-rating anxiety scale(SAS), and Constant-Murley score of shoulder function were assessed pre-operatively and at the last follow-up. Complications relating to the surgery were recorded.
RESULTS:All 8 patients successfully followed up. The mean follow-up after reverse total shoulder arhroplasty ranged from 16 to 28 months. The range of motion (forward flexion, external rotation, abduction and internal rotation) of the affected shoulder was significantly improved after surgery, and the post-operative VAS, SAS and UCLA scores were also significantly improved. For the Constant-Murley score of shoulder joint function, the total scores and the subscores of pain, daily activities, range of motion and strength test at the last follow-up were all significantly improved. Scapular glenoid notch was observed in patient, which was evaluated as grade 1 on imaging. All the other patients did not develop specific or non-specific complications.
CONCLUSION:Reverse total shoulder arhroplasty is an appropriate treatment as a revision surgery for failed fixation of proximal humeral fractures. It has shown satisfactory clinical outcomes, accelerating the rehabilitation of shoulder function and improving the quality of life.
