Radiological Analysis of Proximal Humerus Restoration and Functional Outcome in Shoulder Hemiarthroplasty

Abstract Introduction. The main objective of hemiarthroplasty is to restore the shoulder into the state of fully functional and pain-free. The most important steps in performing hemiarthroplasty are during obtaining proper head height and shaft length, retroversion correction, and tuberosities fixation. Literatures have shown significant improvement on patients performed shoulder hemiarthroplasty, either in the short and medium term or in the long term.Methods. We did a retrospective cohort on patients with neglected proximal humerus fracture who underwent shoulder hemiarthroplasty at several hospitals in Jakarta, including Fatmawati general hospital, Siaga Raya hospital, Siloam hospital and Mitra Kemayoran hospital. Patients who underwent surgery within 2015 to 2018 were enrolled in this study. All patients with neglected Neer 3-part or Neer 4-part proximal humerus fracture, confirmed by x-ray and computed tomography scans, were included. Patients were referred to the surgeon at least 2 weeks after injuryResult. Hemiarthroplasty result in satisfactory functional outcomes, with ASES score Preoperative (median (range)) 4.9 (5-37) improved to Postoperative (Mean±SD) 67.27 ± 13.37. Despite the Age at surgery (years, Mean±SD) 63.87 ± 14.65 are in the elderly group and timing of the operation relative to the initial trauma is (median, range) 13 weeks (2-156), hemiarthroplasty still result in a satisfactory functional outcome even though our patients fracture pattern were Neer 3 and Neer 4.Conclusion. Hemiarthroplasty in neglected three- and four- part proximal humerus fracture is positively correlated with satisfactory clinical and functional outcomes even with associated AVN of humeral head despite the age and the timing of operation.

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Factors Influencing the Varus Deformity of Humeral Head in Proximal Humerus Fractures and Its Relation to Functional Outcome

Indian Journal of Orthopaedics ◽

10.1007/s43465-020-00275-4 ◽

2021 ◽

Author(s):

H. Kantharaju ◽

Sangeet K. Gawhale ◽

G. S. Prasanna Kumar ◽

Balu Sahare ◽

Nadir Shah

Keyword(s):

Functional Outcome ◽

Humeral Head ◽

Proximal Humerus ◽

Varus Deformity ◽

Proximal Humerus Fractures ◽

Factors Influencing ◽

Humerus Fractures

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Study of the functional outcome of unstable and displaced proximal humerus fracture in elderly treated with closed reduction and multiple percutaneous K wire fixation

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2020.v6.i3g.2234 ◽

2020 ◽

Vol 6 (3) ◽

pp. 429-432

Author(s):

Dr. Rajesh Kishan Ambulgekar ◽

Dr. Vishal Ramesh Shewale

Keyword(s):

Functional Outcome ◽

Closed Reduction ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Humerus Fracture ◽

Wire Fixation

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FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i4.1407 ◽

2021 ◽

Vol 10 (4) ◽

pp. 3266-3269

Author(s):

Abhishek Patil

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Proximal Humerus ◽

Constant Score ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Humerus Fractures ◽

The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

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