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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(06): 748-754
DOI: 10.1055/s-0039-3402459
Artigo Original
Ombro e cotovelo

Tuberosity Healing after Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Is there Clinical Improvement?

Article in several languages: português | English
Luís Henrique Barros 
1   Departamento de Ortopedia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
,
Sérgio Figueiredo
2   Departamento de Ortopedia, Centro Hospitalar de Leiria, Leiria, Portugal
,
Manuel Marques
3   Departamento de Ortopedia, Centro Hospitalar do Litoral Alentejano, Santiago do Cacém, Portugal
,
Claudia Rodrigues
1   Departamento de Ortopedia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
,
Joaquim Ramos
1   Departamento de Ortopedia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
,
Rui Claro
1   Departamento de Ortopedia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Abstract

Objective To compare the functional results of patients with complex proximal humerus fracture submitted to total shoulder reverse arthroplasty with and without tuberosity healing. The secondary goal was to know the tuberosity healing rate after reverse shoulder arthroplasty with our surgical technique.

Methods A retrospective, cohort type study, with a prospective database collection. In total, 28 patients fulfilled the inclusion criteria: age ≥ 65 years, reverse shoulder arthroplasty for complex proximal humerus fracture (type-3 or -4, according to Neer), and a minimum of 24 months of follow-up. At six months of follow-up, all of the patients were evaluated radiographically for tuberosity, and then they were divided into 2 groups: those with healed tuberosities and those with non-healed tuberosities. A clinical evaluation using the Constant score, active range of motion and the Visual Analog Scale (VAS) at the last follow-up was also performed.

Results Tuberosity healing occurred in 21 patients (76.3%). There were statistically significant differences in the Constant scoring system (p < 0.001), forward elevation (p = 0.020), internal rotation (p = 0.001) and external rotation (p = 0.003) when comparing the group of healed tuberosities with the group of non-healed tuberosities. No differences were found regarding the VAS score.

Conclusion Tuberosity healing results in an improvement of the functional outcomes of patients submitted to reverse shoulder arthroplasty as a treatment for complex proximal humeral fractures in the elderly.

Keywords

reverse shoulder arthroplasty - tuberosity healing - elderly fracture - proximal humeral fracture


Publication History

Received: 09 January 2019

Accepted: 15 August 2019

Article published online:
07 February 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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