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Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: Multicenter retrospective study

Bonnevialle, Nicolas and Tournier, Clément and Clavert, Philippe and Ohl, Xavier and Sirveaux, François and Saragaglia, Dominique and Société Française de Chirurgie Orthopédique et Traumatologie, Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: Multicenter retrospective study. (2016) Orthopaedics & Traumatology: Surgery & Research, 102 (5). 569-573. ISSN 1877-0568

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Official URL: https://doi.org/10.1016/j.otsr.2016.02.014

Abstract

Introduction: Complex 4-part fractures of the proximal humerus are one of the most difficult fractures to manage. For several years, reverse total arthroplasty (RSA) has been proposed as an alternative to hemiarthroplasty (HA) when internal fixation is insufficient. The goal of this study was to compare the short and intermediate term results of these 2 different types of arthroplasty. Materials and methods: In a retrospective, multicenter study, 57HA and 41 RSA were reviewed after a follow-up of at least 2 years. The clinical evaluation was based on the absolute and adjusted Constant scores, Simple shoulder value (SSV) and the quick-DASH scores. The radiological assessment included standard radiological tests. Results: After a mean follow-up of 39 months, the RSA group had a significantly higher adjusted Constant score than the HA group (83% vs 73%, respectively P = 0.02). However, there was no significant difference in the absolute Constant score, the quick-DASH or the SSV scores. Active anterior elevation was better in the RSA group, while internal rotation was better in the HA group (130◦ vs 112◦, P = 0.01; sacrum vs L3, P = 0.03). There was no significant difference in external rotation (28◦ vs 23◦, P = 0.31). The rate of complications was higher in the HA group than in the RSA group (24% vs 10%, P = 0.01). The radiological rate of union of the greater tuberosity was similar in both groups (70%) and scapular notching was found in 23% of the RSA group. Conclusion: The short and intermediate term clinical outcomes are better with RSA than with HA. The complication rate is higher with HA. Nevertheless, scapular notching occurred in more than 20% of patients with RSA, suggesting that care should be taken when using this prosthesis in young, active patients.

Item Type:Article
Additional Information:Thanks to Elsevier editor. The definitive version is available at http://www.sciencedirect.com The original PDF of the article can be found at https://www.sciencedirect.com/science/article/pii/S1877056816300032
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Centre Hospitalier Universitaire de Reims - CHU Reims (FRANCE)
Other partners > Hôpitaux universitaires de Strasbourg - HUS (FRANCE)
Other partners > Centre Hospitalier Universitaire de Bordeaux - CHU (FRANCE)
Other partners > Centre Hospitalier Universitaire Grenoble Alpes - CHU Grenoble Alpes (FRANCE)
Other partners > Centre Hospitalier Universitaire de Nancy - CHU Nancy (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
Other partners > Société Française de Chirurgie Orthopédique et Traumatologie - SOFCOT (FRANCE)
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Deposited By: Pascal SWIDER
Deposited On:07 Nov 2017 14:48

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