Shoulder arthroplasty as a treatment for sequelae of proximal humeral fractures

• DOI: 10.1007/s00590-010-0630-8
• Publication Date: 2010-06-12T01:34:08Z
• Authors: Amr M. Abdelhady
• Keywords: Avascular Necrosis; Malunion; Acromioplasty; Greater Tuberosity; Impingement syndrome; Shoulder Fracture

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. 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. 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. 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.