27 Hemiarthroplasty For 4-Part Fractures Of The Proximal Humerus: Is It A Good Treatment Option?
Objective: We examined the clinical, functional and radiological outcomes in patients 65 years and older who underwent primary shoulder hemiarthroplasty for a 4-part acute fracture of the proximal humerus, and evaluated efficacy of treatment, patient satisfaction and our procedural deficiencies.Patients and Methods: Eighteen patients were treated with primary hemiarthroplasty for acute proximal humerus Neer type-IV fracture. During follow-up, active forward elevation, abduction, internal/external rotation of the shoulder were assessed.
___
- [1] Boons HW, Goosen JH, van Grinsven S, van Susante JL, van Loon
CJ. Hemiarthroplasty for humeral four-part fractures for patients
65 years and older: a randomized controlled trial. Clin Orthop
Relat Res. 2012 Dec; 470 (12): 3483-91.
[2] Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the
epidemiology of proximal humeral fractures. Clin Orthop Relat
Res. 2006 Jan; 442: 87-92.
[3] Nguyen TV, Center JR, Sambrook PN, Eisman JA. Risk factors
for proximal humerus, fore arm and wrist fractures in theelderly
men and women: the Dubbo Osteoporosis Epidemiology Study.
Am J Epidemiol. 2001 Mar 15;153 (6): 587-95.
[4] Court-Brown CM, Garg A, McQueen MM. The epidemiology of
proximal humeral fractures. Acta Orthop Scand. 2001 Aug;
72 (4): 365-71.
[5] Rees J, Hicks J, Ribbans W. Assessment and management of three
and four part proximal humeral fractures. Clin Orthop Relat
Res. 1998 Aug; (353): 18-29
[6] Shah N, Iqbal HJ, Brookes-Fazakerley S, Sinopidis C. Shoulder
hemiarthroplasty for the treatment of three and four part fractures
of the proximal humerus using Comprehensive® Fracture stem. Int
Orthop. 2011 Jun; 35(6): 861-7.
[7] Mighell MA, Kolm GP, Collinge CA, et al. Outcomes of
hemiarthroplasty for fractures of the proximal humerus. J Shoulder
Elbow Surg. J Shoulder Elbow Surg. 2003 Nov-Dec;12(6):569-77.
[8] Gregory TM, Vandenbussche E, Augereau B. Surgical treatment
of three and four-part proximal humeral fractures. OrthopTraumatol
Surg Res. 2013 Feb; 99 (1 Suppl): 197-207.
[9] Hawkins RJ, Angelo RL. Displaced proximal humeral fractures.
Selecting treatment, avoiding pitfalls. Orthop Clin North Am. 1987
Jul; 18 (3): 421–31.
[10] Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D.
Tuberosity malposition and migration: reasons for poor outcomes
after hemiarthroplasty for displaced fractures of theproximal
humerus. J Shoulder Elbow Surg. 2002 Sep-Oct;11(5): 401-12.
[11] Owsley KC, Gorczyca JT. Fracture displacement and screw cut
out after open reduction and locked plate fixation of proximal
humeral fractures [corrected]. J Bone Joint Surg Am. 2008
Feb; 90 (2): 233-40.
[12] Lanting B, MacDermid J, Drosdowech D, Faber KJ. Proximal
humeral fractures: a systematic review of treatment modalities. J
Shoulder Elbow Surg. 2008 Jan-Feb; 17 (1): 42-54.
[13] Iannotti JP, Ramsey ML, Williams GR Jr, Warner JJ. Nonprosthetic
management of proximal humeral fractures. Instr Course Lect.
2004; 53: 403–16.
[14] Neer CS 2nd et al: Displaced proximal humeral fractures I.
Classification and evaluation. J Bone Joint Surg Am. 1970
Sep; 52 (6): 1077-89
[15] Spross C, Platz A, Erschbamer M, Lattmann T, Dietrich M. Surgical
treatment of Neer Group VI proximal humeral fractures:
retrospective comparison of PHILOS® and hemiarthroplasty. Clin
Orthop Relat Res. 2012 Jul; 470 (7): 2035-42.
[16] Edelson G, Safuri H, Salami J, Vigder F, Militianu D. Natural
history of complex fractures of the proximal humerus using a threedimensional
classification system. J Shoulder Elbow Surg.
2008 May-Jun; 17 (3): 399-409.
[17] Ozyakın N, Aktuglu K. Treatment of the four-part proxsimal
humerus fractures in elderly patients with hemiarthroplasty. Joint
Dis Rel Surg. 2008; 19 (3): 101-105.
[18] Leyshon R. Closed treatment of fractures of the proximal humerus.
Acta Orthop Scand. 1984 Feb; 55 (1): 48-51.
[19] Hartsock LA, Estes WJ, Murray CA, Friedman RJ. Shoulder
hemiarthroplasty for proximal humeral fractures. Orthop Clin
North Am. 1998 Jul; 29 (3): 467-75.
[20] Robinson CM, Page RS, Hill RMF, Sanders DL, Court-Brown
CM, Wakefield AE. Primary hemiarthroplasty for treatment of
proximal humeral fractures. J Bone Joint Surg Am. 2003 Jul;
85-A(7): 1215-23.
[21] Ko JY, Yamamoto R: Surgical treatment of complex fracture of the
proximal humerus. Clin Orthop Relat Res. 1996 Jun;
(327): 225-37.
[22] DeFranco MJ, Brems JJ, Williams GR JR, et al: Evaluation and
management of valgus impacted four-part proximal humerus
fractures. Clin Orthop Relat Res. 1996 Jun; (327): 225-37.
[23] Tingart MJ, Apreleva M, vonStechow D, Zurakowski D, Warner
JJ. The cortical thickness of the proximal humeral diaphysis
predicts bone mineral density of the proximal humerus. J Bone
Joint Surg Br. 2003 May; 85 (4): 611-7.
[24] Nho SJ, Brophy RH, Barker JU, et al: Innovations in the management
of displaced proximal humerus fractures. J Am Acad Orthop Surg.
2007 Jan;15 (1): 12-26.
[25] Demirhan M, Kilicoglu O, Altinel L, Eralp L, Akalin Y. Prognostic
factors in prosthetic replacement for acute proximal humerus
fractures. J Orthop Trauma. 2003 Mar; 17(3): 181-8;
discussion 188-9.
[26] Plausinis D, Kwon YW, Zuckerman JD. Complications of humeral
head replacement for proximal humeral fractures. Instr Course
Lect. 2005; 54: 371-80.
[27] Sirveaux F, Roche O, Molé D. Shoulder arthroplasty for acute
proximal humerus fracture. OrthopTraumatol Surg Res.
2010 Oct; 96 (6): 683-94.
[28] Krishnan SG, Pennington S, Burkhead W. Shoulder arthroplasty
for fracture: restoration of the ‘‘gothicarch’’. Techniques Shoulder
Elbow Surg. 2005; 6: 57-66.
[29] Gerber A, Warner JJ. Hemiarthroplasty for management of complex
proximal humerus fractures: preoperative planning and surgical
solution. In: Warner JJ, Iannotti JP, FlatowE, editors. Complex and
revision problems in shoulder surgery. 2nd ed. Philadelphia:
Lippincott Williams &Wilkins; 2005. p.311—29.
[30] Murachovsky J, Ikemoto RY, Nascimento LG, Fujiki EN, MilaniC,
Warner JJ. Pectoralis majör tendon reference (PMT): a new
method for accurate restoration of humeral length with
hemiarthroplasty for fracture. J Shoulder Elbow Surg. 2006 Nov-
Dec; 15 (6): 675-8.
[31] Greiner SH, Kaab MJ, Kroning I, Scheibel M, Perka C.
Reconstruction of humeral length and centering of the prosthetic
head in hemiarthroplasty for proximal humeral fractures. J Shoulder
Elbow Surg. 2008 Sep-Oct; 17 (5): 709-14.
[32] Cofield RH. Comminuted fractures of the proximal humerus. Clin
Orthop Relat Res. 1988 May; (230): 49-57.
[33] Bigliani LU, Flatow EL, Pollock RG. Fractures of the proximal
humerus. In: Rockwood CA, Matsen FA 3rd, editors. The Shoulder.
Vol 1, 2nd ed. Philadelphia: W.B.Saunders; 1998. p. 337-91.
[34] Kralinger F, Schwaiger R, Wambacher M, Farrell E, Menth-Chiari
W, Lajtai G, Hübner C, Resch H. Outcome after primary
hemiarthroplasty for fracture of the head of the humerus. A
retrospective multicentre study of 167 patients. J Bone Joint Surg
Br. 2004 Mar; 86 (2): 217-9.
[35] Frankle MA, Mighell MA. Techniques and principles of tuberosity
fixation for proximal humeral fractures treated with hemiarthroplasty.
J Shoulder Elbow Surg. 2004 Mar-Apr; 13 (2): 239-47.
[36] Iannotti JP, Gabriel JP, Schneck SL, Evans BG, Misra S. The
normal glenohumeral relationships. An anatomical study of one
hundred and forty shoulders. J Bone Joint Surg Am. 1992 Apr;
74 (4): 491-500.