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. 2021 Sep 24;22(1):38.
doi: 10.1186/s10195-021-00597-5.

Reverse shoulder arthroplasty in complex fractures of the proximal humerus: results after 7 years of follow-up

Alberto Izquierdo-Fernández  1 , Marta Gómez-Rodríguez  1 , Maite Urbano-Luque  1 , Manuel García-Carmona  1 , Rafael Quevedo-Reinoso  1 , José Carlos Minarro  2   3
Affiliations

Reverse shoulder arthroplasty in complex fractures of the proximal humerus: results after 7 years of follow-up

Alberto Izquierdo-Fernández et al. J Orthop Traumatol. .

Abstract

Background: There is still little information about the long-term results of clinical and radiological evolution in patients older than 65 years with complex proximal humerus fractures (CPHF) treated acutely with reverse shoulder arthroplasty (RSA). The aim of this paper was to evaluate function and results 7 years after surgery.

Material and methods: A prospective cross-sectional cohort study was designed for this purpose. Patients who underwent RSA surgery during 2012 because of a CPHF were included. The surgical approach was randomized (deltopectoral vs anterosuperior). Functional activity, evolution of tuberosities and evidence of scapular notching 7 years after surgery were analyzed.

Results: After evaluating 32 patients, the Constant score improved from 64.83 in the first year to 69.54 at 7 years postoperative. Results were independent of the approach used. Functional outcomes were poorer in patients with scapular notching and when tuberosities were resorbed or displaced.

Conclusions: At 7 years, function in patients undergoing RSA after CPHF demonstrated improvement in all patients except those who developed scapular notching or when tuberosities did not consolidate in an anatomical position. These results are completely independent of the approach used.

Level of evidence: III Controlled cohort study.

Keywords: Elderly patient; Outcomes; Proximal humerus fracture; Reverse shoulder arthroplasty; Scapular notching.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Boxplot charts where we can observe function (according to Constant and HSS) in both approaches used 1 year after surgery. Same letters indicate no statistically significant differences between them (p < 0.05, a and b). AS anterosuperior, DP deltopectoral
Fig. 2
Fig. 2
Boxplot chart where we can observe function (according to Constant and HSS) in both approaches used 7 years after surgery. Same letters indicate no statistically significant differences between them (p < 0.05, a and b). AS anterosuperior, DP deltopectoral
Fig. 3
Fig. 3
Boxplot chart where we can observe function (according to Constant and HSS) in relation to the state of tuberosities. Same letters indicate no statistically significant differences between them (p < 0.05, a and b). N normal, R resorbed, D displaced
Fig. 4
Fig. 4
These images show X-rays of the same patient, with a complex dislocated fracture of the proximal humerus (A) and his follow-up after 7 years (B)
See this image and copyright information in PMC

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