Functional outcome of patients after shoulder hemiarthroplasty for neglected fractured proximal humerus

Abstract

Introduction. The main objective of hemiarthroplasty is to restore the shoulder into the state of fully functional and pain-free. The most important steps in performing hemiarthroplasty are during obtaining proper head height and shaft length, retroversion correction, and tuberosities fixation. Literatures have shown significant improvement on patients performed shoulder hemiarthroplasty, either in the short and medium term or in the long term.Methods. We did a retrospective cohort on patients with neglected proximal humerus fracture who underwent shoulder hemiarthroplasty at several hospitals in Jakarta, including Fatmawati general hospital, Siaga Raya hospital, Siloam hospital and Mitra Kemayoran hospital. Patients who underwent surgery within 2015 to 2018 were enrolled in this study. All patients with neglected Neer 3-part or Neer 4-part proximal humerus fracture, confirmed by x-ray and computed tomography scans, were included. Patients were referred to the surgeon at least 2 weeks after injuryResult. Hemiarthroplasty result in satisfactory functional outcomes, with ASES score Preoperative (median (range)) 4.9 (5-37) improved to Postoperative (Mean±SD) 67.27 ± 13.37. Despite the Age at surgery (years, Mean±SD) 63.87 ± 14.65 are in the elderly group and timing of the operation relative to the initial trauma is (median, range) 13 weeks (2-156), hemiarthroplasty still result in a satisfactory functional outcome even though our patients fracture pattern were Neer 3 and Neer 4.Conclusion. Hemiarthroplasty in neglected three- and four- part proximal humerus fracture is positively correlated with satisfactory clinical and functional outcomes even with associated AVN of humeral head despite the age and the timing of operation.