Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul;5(4):213-220.

Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?

Adam Seidl  1 , Daniel Sholder  1 , William Warrender  1 , Michael Livesey  1 , Gerald Williams  1 , Joseph Abboud  1 , Surena Namdari  1
Affiliations

Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?

Adam Seidl et al. Arch Bone Jt Surg. 2017 Jul.

Abstract

Background: This study compared the outcomes between patients with proximal humerus fractures (PHF) who underwent acute reverse total shoulder arthroplasty (RSA) to those who underwent an alternative initial treatment before requiring (secondary) RSA.

Methods: Patients who underwent RSA after suffering a PHF were identified. Two year clinical follow-up was required for inclusion. Patients were divided into an acute group (RSA <4 weeks of fracture) and a secondary group. The secondary RSA group was subdivided by initial treatment (non-operative, hemiarthroplasty, open reduction internal fixation (ORIF)). Clinical and radiographic outcomes were compared.

Results: Forty-seven patients met inclusion criteria with 15 in the acute RSA group and 32 in the secondary RSA group. The acute RSA group demonstrated better external rotation (28°) than the secondary RSA group (18°, P=0.0495). The acute RSA group showed a trend towards better Single Assessment Numeric Evaluation (SANE) scores. Tuberosity healing rate was higher in the acute RSA group.

Conclusion: While acute and secondary RSA can yield successful outcomes, acute RSA results in a higher tuberosity healing rate and improved external rotation.

Keywords: Hemiarthroplasty; Non-operative treatment; Open reduction internal fixation; Proximal humerus fracture; Proximal humerus fracture sequelae; Reverse shoulder arthroplasty; Tuberosity healing.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Box plot demonstrating post-operative active external rotation (AER) for each treatment group.
See this image and copyright information in PMC

References

    1. Antuna SA, Sperling JW, Cofield RH. Shoulder hemiarthroplasty for acute fractures of the proximal humerus: a minimum five-year follow-up. J Shoulder Elbow Surg. 2008;17(2):202–9. - PubMed
    1. Cai M, Tao K, Yang C, Li S. Internal fixation versus shoulder hemiarthroplasty for displaced 4-part proximal humeral fractures in elderly patients. Orthopedics. 2012;35(9):e1340–6. - PubMed
    1. Gerber C, Werner CM, Vienne P. Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br. 2004;86(6):848–55. - PubMed
    1. Mighell MA, Kolm GP, Collinge CA, Frankle MA. Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Shoulder Elbow Surg. 2003;12(6):569–77. - PubMed
    1. Neer CS., 2nd Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970;52(6):1077–89. - PubMed

LinkOut - more resources