Anatomic placement of shoulder prosthesis for complex proximal humerus fractures: A modified method for hemiarthroplasty

Abstract

BackgroundThe placement of shoulder prosthesis used for reconstruction of a complex proximal humerus fractures is challenging. To achieve the anatomical placement of prosthesis, we introduced a new operative technique to determine the humerus height and humeral head retroversion. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure.Method34 patients, treated by shoulder arthroplasty for 4-part or 3–part proximal humeral fracture during the period between June 2016 and December 2018, were enrolled in the study. Eventually 29 patients, 18 women and 11 men with an average age of 68.4 years (range 58–85 years), were followed up successfully. Of which 13 patients treated with classic method were matched to 19 of the 29 new method treated patients by operation time, blood loss, pain, range of motion, Constant-Murley score and radiologic features.ResultsThere was significant difference between the two treatment groups in operation time (p = 0.024), while there was no significant difference in blood loss (p = 0.078). No significant difference was found between the two treatment groups in Visual Analog scale (p = 0.225), Constant-Murley score (p = 0.930), and radiological outcomes (p = 0.504). There was linear regression and correlation between Constant-Murley score and age (p = 0.027), while there was no linear relationship between status of tuberosity and the function of the shoulder joint (p = 0.931).ConclusionWe introduce a new operative technique to determine the humerus height and humeral head retroversion for shoulder arthroplasty operation. Based on the data, there is linear regression and correlation between Constant-Murley score and age, while there is no linear relationship between status of tuberosity and the function of the shoulder joint. Our present analyses reveal that our protocol is personalized, easy, effective and feasible.Trial registration: https://doi.org/10.1186/ISRCTN28175069.