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Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study

Head-split fractures are proximal humerus fractures (PHF) that result from fracture lines traversing the articular surface. While head-split fractures are rare, surgical treatment of these complex injuries can be extremely challenging and is associated with high rates of complications. Treatment usi...

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Autores principales: Imiolczyk, Jan-Philipp, Brunner, Ulrich, Imiolczyk, Tankred, Freislederer, Florian, Endell, David, Scheibel, Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145800/
https://www.ncbi.nlm.nih.gov/pubmed/35628961
http://dx.doi.org/10.3390/jcm11102835
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author Imiolczyk, Jan-Philipp
Brunner, Ulrich
Imiolczyk, Tankred
Freislederer, Florian
Endell, David
Scheibel, Markus
author_facet Imiolczyk, Jan-Philipp
Brunner, Ulrich
Imiolczyk, Tankred
Freislederer, Florian
Endell, David
Scheibel, Markus
author_sort Imiolczyk, Jan-Philipp
collection PubMed
description Head-split fractures are proximal humerus fractures (PHF) that result from fracture lines traversing the articular surface. While head-split fractures are rare, surgical treatment of these complex injuries can be extremely challenging and is associated with high rates of complications. Treatment using primary reverse shoulder arthroplasty (RSA) has been associated with moderate complication rates and reproducible clinical results. The aim of this study was to evaluate clinical and radiographic outcomes, and complication rates of RSA for head-split PHF. Twenty-six patients were evaluated based on Constant Score (CS) and range of motion of both shoulders and Subjective Shoulder Value (SSV). Radiographic analysis evaluated tuberosity healing, prosthetic loosening and scapular notching. Patients achieved good clinical results with a CS of 73.7 points and SSV of 82% after a mean follow-up of 50 months. The relative CS comparing operated versus the unaffected shoulder was 92%. Greater tuberosity healing was achieved in 61%. Patients who suffered a high-energy trauma reached a significantly greater functional outcome. Patients who suffered multifragmentation to the humeral head performed the worst. There were no cases of loosening; scapular notching was visible in two cases. The complication rate was 8%. RSA is an adequate treatment option with for head-split PHF in elderly patients.
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spelling pubmed-91458002022-05-29 Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study Imiolczyk, Jan-Philipp Brunner, Ulrich Imiolczyk, Tankred Freislederer, Florian Endell, David Scheibel, Markus J Clin Med Article Head-split fractures are proximal humerus fractures (PHF) that result from fracture lines traversing the articular surface. While head-split fractures are rare, surgical treatment of these complex injuries can be extremely challenging and is associated with high rates of complications. Treatment using primary reverse shoulder arthroplasty (RSA) has been associated with moderate complication rates and reproducible clinical results. The aim of this study was to evaluate clinical and radiographic outcomes, and complication rates of RSA for head-split PHF. Twenty-six patients were evaluated based on Constant Score (CS) and range of motion of both shoulders and Subjective Shoulder Value (SSV). Radiographic analysis evaluated tuberosity healing, prosthetic loosening and scapular notching. Patients achieved good clinical results with a CS of 73.7 points and SSV of 82% after a mean follow-up of 50 months. The relative CS comparing operated versus the unaffected shoulder was 92%. Greater tuberosity healing was achieved in 61%. Patients who suffered a high-energy trauma reached a significantly greater functional outcome. Patients who suffered multifragmentation to the humeral head performed the worst. There were no cases of loosening; scapular notching was visible in two cases. The complication rate was 8%. RSA is an adequate treatment option with for head-split PHF in elderly patients. MDPI 2022-05-17 /pmc/articles/PMC9145800/ /pubmed/35628961 http://dx.doi.org/10.3390/jcm11102835 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Imiolczyk, Jan-Philipp
Brunner, Ulrich
Imiolczyk, Tankred
Freislederer, Florian
Endell, David
Scheibel, Markus
Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title_full Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title_fullStr Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title_full_unstemmed Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title_short Reverse Shoulder Arthroplasty for Proximal Humerus Head-Split Fractures—A Retrospective Cohort Study
title_sort reverse shoulder arthroplasty for proximal humerus head-split fractures—a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145800/
https://www.ncbi.nlm.nih.gov/pubmed/35628961
http://dx.doi.org/10.3390/jcm11102835
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