Current Role of Reverse Total Shoulder Arthroplasty for Fractures of the Proximal Humerus

Saunders, Patrick E.; Walker, Jeffrey; Lederman, Evan; McKee, Michael D.

doi:10.1097/bot.0000000000002238

Cited by 3 publications

(2 citation statements)

References 76 publications

(166 reference statements)

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“…Reverse total shoulder arthroplasty as a surgical choice for proximal humeral fractures is mainly indicated in elderly patients, in cases where the rotator cuff is deficient, or when tuberosities are comminuted. The surgical management of the tuberosities for reverse total shoulder arthroplasty in complex fractures is still debated; recent evidence seems to demonstrate that better outcomes can be observed if the tuberosities are reattached and healed [ 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Over the last years, companies have implemented their shoulder stem portfolio, introducing devices specifically aimed to treat proximal humeral fractures.…”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty for Proximal Humeral Fractures: Is the Bigliani-Flatow Stem Suitable for Tuberosity Fixation and Healing?

Bellato,

Fava,

Arpaia

et al. 2024

JCM

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Background/Objectives: The aim of the study was to investigate the clinical, functional, and radiographic results of patients affected by three- or four-part proximal humeral fractures treated with reverse total shoulder arthroplasty, to investigate whether a prosthetic stem nonspecifically designed for fractures (i.e., the Bigliani-Flatow stem) promotes tuberosities’ healing, and to evaluate the impact of tuberosity fixation and healing on the outcomes. Methods: Patients’ data such as gender, age, side and dominancy, comorbidities, complications during or after surgery, and time lapse between trauma and surgery were prospectively collected. The type of fixation of the stem, the thickness and type of liner, and whether the tuberosities were fixed or not were also recorded. The Constant score weighted on the contralateral limb, QuickDASH, Oxford Shoulder Score, and Subjective Shoulder Value were collected. Tuberosities’ healing was assessed with X-rays (anteroposterior, Grashey, and axillary views). Results: Overall, 34 patients were included, with an average follow-up of 42 months. Tuberosities were reinserted in 24 cases and their healing rate was 83%. The mean values were the following: a Constant score of 64, Oxford Shoulder Score of 39, Subjective Shoulder Value of 71, and QuickDASH score of 27. There were no significant differences in the scores or range of motion between patients with tuberosities healed, reabsorbed, or not reattached. There was a better external rotation in the group with healed tuberosities and a longer duration of surgery to reattach tuberosities. Conclusions: The treatment of proximal humerus fractures with the Bigliani-Flatow stem is associated with good clinical and functional results. The healing rate of the tuberosities was high and comparable, if not even better, than the mean rates reported for the stems dedicated to fractures of the proximal humerus and was, therefore, also appropriate for this indication.

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Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty for Proximal Humeral Fractures: Is the Bigliani-Flatow Stem Suitable for Tuberosity Fixation and Healing?

Bellato,

Fava,

Arpaia

et al. 2024

JCM

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show abstract

“…Treatment of PHFs remains a controversial topic, with options including nonoperative, open reduction internal fixation, hemiarthroplasty (HA), and RSA. 14 For comminuted displaced 3-part and 4-part PHF fractures in the elderly, HA had previously been the treatment of choice. 2 , 16 Recently, RSA has emerged as the contemporary favorite treatment modality for displaced 3- and 4-part geriatric PHFs, demonstrating a 1841% increase in incidence from 2010 to 2019.…”

mentioning

confidence: 99%

A proximal humerus fracture with concomitant axillary artery occlusion and axillary nerve palsy treated with reverse total shoulder arthroplasty: a case report

Wright,

Gutowski,

Fedorka

2023

JSES Reviews, Reports, and Techniques

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Clinical and Radiographic Outcome of Open Reduction and Internal Fixation of 3- and 4-Part Proximal Humerus Fractures Augmented with Impaction Bone Grafting and A Magnesium-Based Bone Filler

Patel,

Cogan,

Shemo

et al. 2024

JSES International

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Current Role of Reverse Total Shoulder Arthroplasty for Fractures of the Proximal Humerus

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 3 publications

References 76 publications

Reverse Shoulder Arthroplasty for Proximal Humeral Fractures: Is the Bigliani-Flatow Stem Suitable for Tuberosity Fixation and Healing?

Reverse Shoulder Arthroplasty for Proximal Humeral Fractures: Is the Bigliani-Flatow Stem Suitable for Tuberosity Fixation and Healing?

A proximal humerus fracture with concomitant axillary artery occlusion and axillary nerve palsy treated with reverse total shoulder arthroplasty: a case report

Clinical and Radiographic Outcome of Open Reduction and Internal Fixation of 3- and 4-Part Proximal Humerus Fractures Augmented with Impaction Bone Grafting and A Magnesium-Based Bone Filler

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