Evaluation of results of reverse shoulder arthroplasty in four part fracture of proximal humerus in elderly patients

Atanu Mohanty; Udit Sourav Sahoo; Sibasish Panigrahi; Anuraag Mohanty

Volume : VII, Issue : III, March - 2018

Evaluation of results of reverse shoulder arthroplasty in four part fracture of proximal humerus in elderly patients

Atanu Mohanty, Udit Sourav Sahoo, Sibasish Panigrahi, Anuraag Mohanty

Abstract :

Majority of Neer�s 4–part fracture of proximal humerus in elderly population with osteoporosis, complex fracture pattern, and tuberosity comminution are unsuitable for internal fixation, owing to the high incidence of avascular necrosis [1,2]. Hemiarthroplasty although recommended in such scenario, results have been unreliable. Reverse shoulder replacement has been advocated as alternative with promising results, as functional recovery is possible without anatomic tuberosity healing or intact rotator cuff[3,7]. We used reverse shoulder arthroplasty in 16 consecutive patients with a mean age 54.2 year. The mean active anterior elevation was 154� (130�– 175º), mean active lateral elevation was 150˚(125º–170̊); mean active external rotation in adduction was 42�. Pre–operatively, the mean Constant score of the contralateral shoulders were 82.5(74–90). Postop,mean Constant score was 62, mean pain score 14.3, mean activity score was 2, mean mobility score 30.8, and mean strength score 4.4.Mean ASES score was 72 and mean DASH score was at 35 out of 100. 1 case developed heterotopic ossification and 2 had scapular notching. More long–term and higher level randomized studies to compare with hemiarthroplasty and ORIF are needed in future to draw any firm conclusion.