Acute Surgical Management of Proximal Humerus Fractures: ORIF vs Hemiarthroplasty vs Reverse Shoulder Arthroplasty

Yahuaca, B. Israel; Patel, Shaan; Christmas, Kaitlyn N.; Simon, Peter; Mighell, Mark A.; Frankle, Mark A.

doi:10.1016/j.jse.2020.01.046

Cited by 17 publications

(22 citation statements)

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“…Gupta et al [11] reported a higher reoperation rate of 12.7% in ORIF vs 5% in RSA. Yahuaca et al [10] noted the same results with 17.1% in ORIF vs 6.6% in RSA.…”

Section: Discussionmentioning

confidence: 65%

“…Hardeman et al [9] reported worse functional outcomes and higher re-operation rates when treating old patient with ORIF. Yahuaca et al [10] found the same results with increased non-union and reoperation rates in patients > 65 years old. They attributed these ndings to poorer bone quality in this population.…”

Section: Discussionmentioning

confidence: 68%

“…Age in an important factor when choosing the adequate treatment. Yahuaca et al [10] reported that the majority of patients aged > 65 years old were treated with RSA while the other patients were more likely to undergo a conservative surgical treatment. These ndings were consistent with Gupta's et al [11] in their systemic review of studies comparing ORIF, hemiarthroplasty and RSA for fractures of proximal humerus.…”

Section: Discussionmentioning

confidence: 99%

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Reverse Shoulder Arthroplasty Versus Antegrade Nailing for 3- and 4-Part Proximal Humeral Fractures in Elderly Patients.

Amri

Ayari

TLEMSANI

et al. 2020

Preprint

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Introduction: Proximal humerus fractures are prevalent and widespread, accounting for 5% of all fractures, mainly in the elderly osteoporotic patients following a low-level trauma. Three-and four-part fractures represent 13 to 16% of these fractures and are generally associated with a worse prognosis. Depending on the fracture type and the patient status, several therapeutic options would be available ranging from osteosynthesis to arthroplasty. The aim of our study was to compare the functional and radiological results, as well as the complications of reverse shoulder arthroplasty and anterograde nailing when managing these fractures. Methods: A retrospective and descriptive study was conducted within the orthopedic surgery department of the Military Hospital of Instruction of Tunis, over a period of 42 months, from January 2016 to June 2019 with an average follow-up of 18 months. We included 31 cases of complex fractures of the proximal humerus in elderly patients, aged over 65 years, 16 of whom were treated by reverse total arthroplasty and 15 by antegrade nailing. Results: Our patient pool included 8 men and 23 women with a mean age of 73 years, ranging from 65 to 85. A low-energy fall was the main cause of the fractures with the dominant side being affected in 55% of cases. Four-part fractures were predominant representing 68% of the fractures. Constant and DASH scores at the last follow-up were at 68 and 24 respectively. Most patients were satisfied with the outcome of their surgeries, with an overall satisfaction rate of 87%. The complications rate was in accordance with the literature. Functional results in the group treated with reverse total shoulder arthroplasty were better with a lower complications rate. Conclusion: Reverse total shoulder arthroplasty has become an interesting surgical alternative, as the functional and anatomical results in our study were promising, while elucidating an improved quality of life for our patients. These findings have encouraged us to continue using this technique as a first-line choice for complex fractures of the proximal humerus in the elderly

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“…Gupta et al [11] reported a higher reoperation rate of 12.7% in ORIF vs 5% in RSA. Yahuaca et al [10] noted the same results with 17.1% in ORIF vs 6.6% in RSA.…”

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reverse Shoulder Arthroplasty Versus Antegrade Nailing for 3- and 4-Part Proximal Humeral Fractures in Elderly Patients.

Amri

Ayari

TLEMSANI

et al. 2020

Preprint

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“…Some more papers appeared a year later [6,7,8] and they all concluded that RSA is a promising tool for selected patients. Later studies sustained a hypothesis that RSA gives better results than hemiarthroplasty (HA), especially in final flexion and abduction of the arm, as well as lower pain score (VAS) and higher patient's overall satisfaction [9,14,15,17,19,23].…”

Section: Introductionmentioning

confidence: 99%

Reversed shoulder arthroplasty in treatment of proximal humeral fractures – early results in Department of Orthopaedics, Traumatology and Oncology, Regional Hospital in Torun, Poland

Kilian¹,

Bojańczyk²,

Jackowiak³

2021

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. Proximal humeral fractures (PHF) are a frequent finding, and still growing part of it needs to be treated operatively. Extending life expectancy, increasing percentage of osteoporotic fractures and progressive patients’ demand force surgeons to seek the best solutions of treating complex fractures. Just some teen years ago older patients who suffered a severe PHF were doomed to shoulder dysfunction. Today we can offer them a reversed shoulder arthroplasty (RSA) Purpose. The aim of the paper was a clinical evaluation of the patients who were treated with RSA in a Regional Hospital. Material and Methods. In years 2017-2021 in our department there were performed 41 RSAs and 5 TSAa (total anatomic shoulder arthroplasty). Earlier in 2010-2017 we performed 26 hemiarthroplasties. The procedures were done via delto-pectoral approach. The implant used were Aequalis Reversed Fracture (Tornier) and SMR (Lima). Results. The patients were evaluated in a simplified manner after 6 months postop. Functional active range of motion and VAS score were noted. Conclusions. In our department RSA is a well adopted method of treating complex PHFs, especially in elderly patients, and it yields overall good results and great percentage of satisfied patients.

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“…PHFs are commonly managed either nonoperatively (with slings, braces and physiotherapy) or operatively (fixation with screws, intramedullary nails, locking plates, percutaneous techniques, hemiarthroplasty, reverse arthroplasty). 1,[3][4][5] Numerous publications have attempted to guide PHF treatment. An influential recent study was the Proximal Fracture of the Humerus Evaluation by Randomization (ProFHER) article.…”

Section: Introductionmentioning

confidence: 99%

Quotation errors related to the Proximal Fracture of the Humerus Evaluation by Randomization (ProFHER) study

Bagga¹,

Cay²,

Ricketts³

et al. 2020

Shoulder & Elbow

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Aim The aim of this study was to assess the accuracy of quotations of the Proximal Fracture of the Humerus Evaluation by Randomization (ProFHER) study in the published literature. Methods A literature search was performed from March 2015 to November 2019 to identify all papers that reference ProFHER since its publication. Full text articles were reviewed by two independent reviewers using a validated framework of assessing quotation errors. A kappa co-efficient was calculated to assess interobserver reliability of the reviewers. Results There were 260 individual ProFHER quoted references within the 138 included articles. We identified 35/260 quotation errors (13%). Of these, 10/35 (29%) were major quotation errors and 25/35 (71%) minor quotation errors. There was substantial interobserver agreement when errors were classified. Of the 10 major errors, six quotations were not substantiated by the results of ProFHER and three were unrelated to ProFHER. One paper contained a quotation error that contradicted the results of ProFHER. Of the 25 minor errors, 19 oversimplified or generalised the conclusions of ProFHER and six contained numerical or grammatical errors. Conclusion The current study demonstrated substantial inaccuracies in quotations of the Proximal Fracture of the Humerus Evaluation by Randomization study. Vigilance is recommended when quoting the literature and reviewing submitted papers in order to prevent the perpetuation of misquoted data.

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Acute Surgical Management of Proximal Humerus Fractures: ORIF vs Hemiarthroplasty vs Reverse Shoulder Arthroplasty

Cited by 17 publications

References 0 publications

Reverse Shoulder Arthroplasty Versus Antegrade Nailing for 3- and 4-Part Proximal Humeral Fractures in Elderly Patients.

Reverse Shoulder Arthroplasty Versus Antegrade Nailing for 3- and 4-Part Proximal Humeral Fractures in Elderly Patients.

Reversed shoulder arthroplasty in treatment of proximal humeral fractures – early results in Department of Orthopaedics, Traumatology and Oncology, Regional Hospital in Torun, Poland

Quotation errors related to the Proximal Fracture of the Humerus Evaluation by Randomization (ProFHER) study

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