Posterior dislocation of the shoulder may be missed or neglected at initial presentation especially in developing countries. We present a case of 40-year-old Indian man who had 3-month missed posterior dislocation of the right shoulder along with malunited fracture of the anatomical neck of the humerus. Open reduction and stabilization with modified McLaughlin procedure was performed. Rotational osteotomy of proximal humerus had to be performed as supplementary procedure to keep the humeral head stable in glenoid cavity during functional range of movements. The patient had excellent result of the shoulder at 3 years follow-up.
Humans ; Humerus ; Osteotomy ; Shoulder Dislocation ; surgery ; Shoulder Fractures ; surgery

Arthroplasty, Replacement ; methods ; Clavicle ; injuries ; Fractures, Bone ; surgery ; Humans ; Joint Instability ; surgery ; Shoulder Fractures ; surgery ; Shoulder Injuries ; Shoulder Joint ; surgery

Fracture Fixation, Internal ; Humans ; Humerus ; surgery ; Shoulder Fractures ; surgery

OBJECTIVETo investigate the relationship of the greater tuberosity and the lateral fin of the prosthesis by using cadaveric research.

METHODSNine pairs of fresh-frozen upper extremity specimens (n = 18) were collected. Two-part anatomical neck fracture models were created by osteotomy along the anatomical neck. A standardized humeral head replacement procedure was carried out. The prosthesis was implanted in 20 degrees and 40 degrees of retroversion respectively, and the distance between the bicipital groove and lateral fin of the prosthesis was measured.

RESULTSThe lateral fins of prostheses in all specimens were located behind the bicipital groove. The average distances were 7.3 mm in 20 degrees retroversion and 4.0 mm in 40 degrees retroversion.

CONCLUSIONIt is better to fix the greater tuberosity over the lateral fin during humeral head replacement.

Arthroplasty, Replacement ; methods ; Humans ; Humerus ; anatomy & histology ; surgery ; Shoulder Fractures ; surgery ; Shoulder Joint ; anatomy & histology ; surgery

Arthroplasty, Replacement, Shoulder ; Humans ; Humeral Head ; Shoulder Fractures ; surgery ; Shoulder Joint

OBJECTIVETo investigate the indication, perioperative announcements, selection of prosthesis and clinical results of shoulder hemiarthroplasty for the treatment of complex proximal humeral fractures.

METHODSA total of 55 patients who suffered from complex proximal humeral fractures were treated by shoulder hemiarthroplasty. The mean age was 55.6 years and mean follow-up period was 25.1 months. The scoring system modification for hemiarthroplasty (SSMH) had been adopted for evaluation at the latest follow-up.

RESULTSThe pain was obviously relieved in all patients. Fifty patients were painless and 5 patients had slight pain. The mean range of motion was 100 degrees (90 degrees-110 degrees) in abduction, 95 degrees (80 degrees-100 degrees) in forward flexion, 35 degrees (30 degrees-40 degrees) in external rotation and internal rotation was confined at L2 level (L1-L3). The mean SSMH score was 27.9 (24-29). Fifty patients (90.1%) were satisfied with the clinical outcome.

CONCLUSIONSShoulder hemiarthroplasty is an effective method to treat complex proximal humeral fractures. The proper selection of patients and prosthesis, good operation skill and enough functional exercise are the key points of successful treatment.

Adult ; Aged ; Arthroplasty, Replacement ; methods ; Female ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Shoulder Joint ; surgery

Adult ; Humans ; Humeral Head ; injuries ; Male ; Shoulder Fractures ; surgery

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.
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

Humans ; Fracture Fixation, Internal ; Shoulder Fractures/surgery* ; Bone Plates ; Treatment Outcome ; Humeral Fractures/surgery*

OBJECTIVE: To investigate clinical results of reverse total shoulder arthroplasty in treating comminuted fracture of proximal humerus in elderly patients with rotator cuff injury. METHODS: From January 2017 to December 12, 12 comminuted fracture or dislocation of proximal humerus elderly patients were diagnosed as rotator cuff injury by preoperative MRI and operative exploration, and treated by reverse total shoulder arthroplasty. Among them, including 7 males and 5 females aged from 65 to 86 years old; 5 patients injured on the left side and 7 patients injured on the right side. Range of motion, postoperative complication were observed, VAS score was used to evaluate pain release and UCLA score was used to assess recovery of shoulder joint. RESULTS: All patients were followed up from 8 to 18 months. At the latest follow-up, shoulder range of motion conditions were as following:forward bend and lifts ranged from 90° to 150°, external rotation ranged from 10°to 30°, internal rotation could reached L₃ level(S₁-L₁), VAS was for 0 to 6 points, UCLA score ranged from 18 to 32 points, 5 patients were good and 7 patients were poor. No infection, prothesis loosening, shoulder stress fracture, injury of vessel and nerve occurred. CONCLUSIONS Reverse total shoulder arthroplasty in treating comminuted fracture of proximal humerus in elderly patients with rotator cuff injury has advantages of early recovery of shoulder joint range of motion, less pain and high patients' satisfactory.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Shoulder ; Female ; Fractures, Comminuted ; Humans ; Humerus ; Male ; Range of Motion, Articular ; Rotator Cuff Injuries ; Shoulder ; Shoulder Fractures ; surgery ; Shoulder Joint ; Treatment Outcome