Abstract
Background: Proximal humeral fractures are common and a major concern in public health resources utilization. There is an increase in the use of reverse total shoulder arthroplasty (RTSA) as an option for complex fractures in the elderly. The complexity of the technique in RTSA is increased because of the fracture. To find an advantage of locking stems in RTSA for the treatment of proximal humeral fractures, we designed a comparative study between fracture-dedicated locking stems vs. cemented stems. Materials and methods: We retrospectively studied 58 patients treated with an RTSA after a fracture. We compared how the implant design and the tuberosity consolidation affects patient outcome through measuring range of motion and the Constant score. Results: The groups were similar in age, sex, time to surgery, and Constant score in the uninjured side. Patients treated with a dedicated locking noncemented stem performed better, with an increased Constant score (P >.05) and reached more mobility with no statistical significance. We found that 13 of the 24 fractures (54%) treated with a cemented stem consolidated, and 26 of 34 tuberosities (76%) healed in the noncemented locked stems. Patients with tuberosity consolidation acquired better range of motion and Constant scores (P <.05). Conclusions: A dedicated stem improves tuberosity healing and increases outcomes seen in Constant scores. Tuberosity consolidation is a main goal when treating proximal humeral fractures with RTSA.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 48-55 |
| Number of pages | 8 |
| Journal | Journal of Shoulder and Elbow Surgery |
| Volume | 28 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- fracture
- humeral
- Level III
- noncemented
- Proximal
- Retrospective Cohort Design
- reverse
- Treatment Study
- tuberosities
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
Early outcomes of locked noncemented stems for the management of proximal humeral fractures : a comparative study. / Jorge-Mora, Alberto; Amhaz-Escanlar, Samer; Fernández-Pose, Sabela; Lope-del-Teso, Cristina; Pino-Mínguez, Jesús; Caeiro-Rey, José Ramón; Pretell, Juan Abelardo Augusto; Gómez, Rodolfo.
In: Journal of Shoulder and Elbow Surgery, Vol. 28, No. 1, 01.01.2019, p. 48-55.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early outcomes of locked noncemented stems for the management of proximal humeral fractures
T2 - a comparative study
AU - Jorge-Mora, Alberto
AU - Amhaz-Escanlar, Samer
AU - Fernández-Pose, Sabela
AU - Lope-del-Teso, Cristina
AU - Pino-Mínguez, Jesús
AU - Caeiro-Rey, José Ramón
AU - Pretell, Juan Abelardo Augusto
AU - Gómez, Rodolfo
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Proximal humeral fractures are common and a major concern in public health resources utilization. There is an increase in the use of reverse total shoulder arthroplasty (RTSA) as an option for complex fractures in the elderly. The complexity of the technique in RTSA is increased because of the fracture. To find an advantage of locking stems in RTSA for the treatment of proximal humeral fractures, we designed a comparative study between fracture-dedicated locking stems vs. cemented stems. Materials and methods: We retrospectively studied 58 patients treated with an RTSA after a fracture. We compared how the implant design and the tuberosity consolidation affects patient outcome through measuring range of motion and the Constant score. Results: The groups were similar in age, sex, time to surgery, and Constant score in the uninjured side. Patients treated with a dedicated locking noncemented stem performed better, with an increased Constant score (P >.05) and reached more mobility with no statistical significance. We found that 13 of the 24 fractures (54%) treated with a cemented stem consolidated, and 26 of 34 tuberosities (76%) healed in the noncemented locked stems. Patients with tuberosity consolidation acquired better range of motion and Constant scores (P <.05). Conclusions: A dedicated stem improves tuberosity healing and increases outcomes seen in Constant scores. Tuberosity consolidation is a main goal when treating proximal humeral fractures with RTSA.
AB - Background: Proximal humeral fractures are common and a major concern in public health resources utilization. There is an increase in the use of reverse total shoulder arthroplasty (RTSA) as an option for complex fractures in the elderly. The complexity of the technique in RTSA is increased because of the fracture. To find an advantage of locking stems in RTSA for the treatment of proximal humeral fractures, we designed a comparative study between fracture-dedicated locking stems vs. cemented stems. Materials and methods: We retrospectively studied 58 patients treated with an RTSA after a fracture. We compared how the implant design and the tuberosity consolidation affects patient outcome through measuring range of motion and the Constant score. Results: The groups were similar in age, sex, time to surgery, and Constant score in the uninjured side. Patients treated with a dedicated locking noncemented stem performed better, with an increased Constant score (P >.05) and reached more mobility with no statistical significance. We found that 13 of the 24 fractures (54%) treated with a cemented stem consolidated, and 26 of 34 tuberosities (76%) healed in the noncemented locked stems. Patients with tuberosity consolidation acquired better range of motion and Constant scores (P <.05). Conclusions: A dedicated stem improves tuberosity healing and increases outcomes seen in Constant scores. Tuberosity consolidation is a main goal when treating proximal humeral fractures with RTSA.
KW - fracture
KW - humeral
KW - Level III
KW - noncemented
KW - Proximal
KW - Retrospective Cohort Design
KW - reverse
KW - Treatment Study
KW - tuberosities
UR - http://www.scopus.com/inward/record.url?scp=85051399290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051399290&partnerID=8YFLogxK
U2 - 10.1016/j.jse.2018.05.036
DO - 10.1016/j.jse.2018.05.036
M3 - Article
VL - 28
SP - 48
EP - 55
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
SN - 1058-2746
IS - 1
ER -