Clinical and radiological outcomes of reverse shoulder arthroplasty for acute fracture in the elderly

2021 ◽  
Author(s):  
Yann Sabah ◽  
Lauryl Decroocq ◽  
Marc Olivier Gauci ◽  
Nicolas Bonnevialle ◽  
Devin Byron Lemmex ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
The Elderly ◽  
Acute Fracture

Reverse shoulder arthroplasty for proximal humeral fracture in the elderly. Cemented or uncemented stem?

2022 ◽  
Author(s):  
Yaiza Lopiz ◽  
Carlos García-Fernandez ◽  
María Vallejo-Carrasco ◽  
Daniel Garriguez-Pérez ◽  
Loreto Achaerandio ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Proximal Humeral Fracture ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Fracture ◽  
The Elderly

scholarly journals Humeral Head Replacement and Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fracturesm

2017 ◽  
Vol 11 (1) ◽  
pp. 1108-1114 ◽  
Author(s):  
Aaron Andrew Frombach ◽  
Kendra Brett ◽  
Peter Lapner
Keyword(s):  
Shoulder Arthroplasty ◽  
New Technology ◽  
Reverse Shoulder Arthroplasty ◽  
Standard Of Care ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Current Evidence ◽  
Complication Rates ◽  
Surgical Fixation

Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain. While not conclusive, the evidence suggests that reverse shoulder arthroplasty yields more consistent results, with improved forward elevation and higher functional outcome scores. The primary advantages of hemiarthroplasty are improved shoulder rotation and shorter operative time. Complication rates do not vary significantly between the two options. Although higher quality trials are needed to further define the role of reverse shoulder arthroplasty, current evidence suggests that this is a reasonable option for surgeons who are highly familiar with its use.

scholarly journals Reverse shoulder arthroplasty for acute fractures in the elderly: is it worth reattaching the tuberosities?

2019 ◽  
Vol 28 (3) ◽  
pp. 437-444 ◽  
Author(s):  
Pascal Boileau ◽  
Tjarco D. Alta ◽  
Lauryl Decroocq ◽  
François Sirveaux ◽  
Philippe Clavert ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
The Elderly

Reverse shoulder arthroplasty for the treatment of three-part and four-part proximal humeral fractures in the elderly

2015 ◽  
Vol 24 (2) ◽  
pp. 215-222 ◽  
Author(s):  
Mark Ross ◽  
Ben Hope ◽  
Andy Stokes ◽  
Susan E. Peters ◽  
Iain McLeod ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures

scholarly journals Reverse Shoulder Arthroplasty for the Treatment of 3 and 4- Part Fractures of the Humeral Head in the Elderly

2017 ◽  
Vol 11 (1) ◽  
pp. 108-118 ◽  
Author(s):  
Ioannis Gigis ◽  
Alexandros Nenopoulos ◽  
Dimitrios Giannekas ◽  
Roderich Heikenfeld ◽  
Theodoros Beslikas ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Fracture ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Long Term Results ◽  
Cochrane Library ◽  
Osteoporotic Bone ◽  
Reverse Prosthesis

Background:Proximal humeral fractures in elderly patients present with severe comminution and osteoporotic bone quality.Reverse shoulder arthroplasty has lately been proven beneficial in treating patients with complex proximal humeral fractures. The above technique is recommended and has better results in elderly than in younger individuals.Methods:We performed a literature search in the databases Pubmed, Medline, EMBASE and Cochrane Library for published articles between 1970 and 2016 using the terms: proximal humerus fractures and reverse shoulder arthroplasty.Results:Significant benefits with the use of reverse prosthesis, especially in patients older than 70 years with a proximal humeral fracture, include reduced rehabilitation time as well as conservation of a fixed fulcrum for deltoid action in case of rotator cuff failure.Compared with hemiarthroplasty and internal fixation, reverse prosthesis may be particularly useful and give superior outcomes in older patients, due to comminuted fractures in osteopenic bones.However, significant disadvantages of this technique are potential complications and a demanding learning curve.Therefore, trained surgeons should follow specific indications when applying the particular treatment of proximal humeral fractures and be familiar with the surgical technique.Conclusion:Although long-term results and randomized studies for reverse prosthesis are lacking, short and mid- term outcomes have given promising results encouraging more shoulder surgeons to use this type of prosthesis in proximal humeral fractures.

scholarly journals Reverse Shoulder Arthroplasty Versus Antegrade Nailing for 3- and 4-Part Proximal Humeral Fractures in Elderly Patients.

2020 ◽  
Author(s):  
Khalil AMRI ◽  
Rabie AYARI ◽  
Karim LATRECH TLEMSANI ◽  
Achraf ABDENNADHER ◽  
Mohamed BEN SALAH ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
The Elderly ◽  
Reverse Total Shoulder Arthroplasty ◽  
Complications Rate ◽  
Reverse Total Shoulder

Abstract Introduction: Proximal humerus fractures are prevalent and widespread, accounting for 5% of all fractures, mainly in the elderly osteoporotic patients following a low-level trauma. Three-and four-part fractures represent 13 to 16% of these fractures and are generally associated with a worse prognosis. Depending on the fracture type and the patient status, several therapeutic options would be available ranging from osteosynthesis to arthroplasty. The aim of our study was to compare the functional and radiological results, as well as the complications of reverse shoulder arthroplasty and anterograde nailing when managing these fractures. Methods: A retrospective and descriptive study was conducted within the orthopedic surgery department of the Military Hospital of Instruction of Tunis, over a period of 42 months, from January 2016 to June 2019 with an average follow-up of 18 months. We included 31 cases of complex fractures of the proximal humerus in elderly patients, aged over 65 years, 16 of whom were treated by reverse total arthroplasty and 15 by antegrade nailing. Results: Our patient pool included 8 men and 23 women with a mean age of 73 years, ranging from 65 to 85. A low-energy fall was the main cause of the fractures with the dominant side being affected in 55% of cases. Four-part fractures were predominant representing 68% of the fractures. Constant and DASH scores at the last follow-up were at 68 and 24 respectively. Most patients were satisfied with the outcome of their surgeries, with an overall satisfaction rate of 87%. The complications rate was in accordance with the literature. Functional results in the group treated with reverse total shoulder arthroplasty were better with a lower complications rate. Conclusion: Reverse total shoulder arthroplasty has become an interesting surgical alternative, as the functional and anatomical results in our study were promising, while elucidating an improved quality of life for our patients. These findings have encouraged us to continue using this technique as a first-line choice for complex fractures of the proximal humerus in the elderly

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