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Case Reports
. 2020 Oct;11(Suppl 5):S752-S755.
doi: 10.1016/j.jcot.2020.06.044. Epub 2020 Jul 8.

Use of reverse stemless shoulder arthroplasty in a patient with multiple hereditary exostosis

Natalie Holmes  1 , Siddharth Virani  1 , Jaikumar Relwani  1
Affiliations
Case Reports

Use of reverse stemless shoulder arthroplasty in a patient with multiple hereditary exostosis

Natalie Holmes et al. J Clin Orthop Trauma. 2020 Oct.

Erratum in

Abstract

Introduction: Multiple hereditary exostosis (MHE) is the formation of benign, cartilage-capped bony outgrowths predominantly extending from the metaphysis of long bones that presents with reduction in growth, deformity, restricted motion, short stature and premature osteoarthritis.

Aim: To review the clinical and radiological results of a stemless reverse shoulder arthroplasty in a case of MHE.

Case: 81-year-old, right hand dominant short-statured retired male engineer with long standing shoulder pain and restricted movements on the background of an old proximal humeral fracture managed conservatively.The radiographs revealed osteoarthritis and a mal-united proximal humerus fracture on the background of MHE with 3 plane bone deformity and a lack of medullary canal.

Results: The patient underwent a stemless reverse shoulder arthroplasty. At 6 months post operatively the patient had recovered well with a range of movement including: forward flexion 110°, external rotation 20° and abduction of 80°. Internal rotation remained limited to buttocks. Improved ADLIER, Subjective shoulder value and Constant Murley score compared to pre-operative figures.

Conclusion: The stemless humeral component relies on metaphyseal impaction for stability. When the humeral canal is malformed or in presence of malunited distal fractures, it circumvents the need of navigating a deformed diaphysis with encouraging postoperative results.

Keywords: Deformity; Fracture; Multiple hereditary exostosis; Osteoarthritis; Shoulder; Stemless prosthesis.

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Figures

Fig. 1
Fig. 1
Fig. 1.1 and 1.2 shows AP and axial x-rays of patients right shoulder at initial presentation.
Fig. 2
Fig. 2
Fig. 2.1 and 2.2: CT of patients right humerus highlighting the non-united comminuted proximal humerus fracture.
Fig. 3
Fig. 3
Fig. 3.1 and 3.2: 3D reconstructed CT of patients’ right shoulder, Aanterior and Posterior views highlighting the underlying deformity of the humuers
Fig. 4
Fig. 4
Fig. 4.1 and 4.2: Day 1 post-operative radiographs of right reverse short stemmed shoulder arthroplasty.
Fig. 5
Fig. 5
Fig. 5.1 and 5.2 showing 1-month post-operative AP and axial right shoulder radiographs.
See this image and copyright information in PMC

References

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