Reverse shoulder arthroplasty for proximal humeral fractures: update on indications, technique, and results.

Abstract

The introduction of the reverse shoulder arthroplasty has provided shoulder surgeons with more options for the treatment of complex proximal humeral fractures in the elderly. Early reported results suggest that the average functional outcome may be better than hemiarthroplasty in certain patients and specific clinical scenarios. In addition, these results seem to be reached more quickly with less dependence on rehabilitation. The reverse prosthesis may be particularly useful in patients aged older than 70 years, especially those with severely comminuted fractures in osteopenic bone. These factors likely have a negative impact on the results of hemiarthroplasty and internal fixation. Despite the potential benefits of reverse arthroplasty for fracture, there is a significant learning curve with the use of this prosthesis, and it has its own set of complications. The surgeon must show appropriate judgment when selecting a reverse arthroplasty in the setting of a proximal humeral fracture and, furthermore, be well acquainted with the surgical technique and prosthetic options at the time of surgery. Although the longevity of this prosthesis remains unknown, midterm outcomes are promising.

• Authors: Daniel C Acevedo, Corinne Vanbeek, Mark D Lazarus, Gerald R Williams, Joseph A Abboud
• Journal: Journal of shoulder and elbow surgery (J Shoulder Elbow Surg) Vol. 23 Issue 2 Pg. 279-89 (Feb 2014) ISSN: 1532-6500 [Electronic] United States
• PMID: 24418780 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Arthroplasty, Replacement (adverse effects, methods)
• Humans
• Middle Aged
• Radiography
• Shoulder Fractures (diagnostic imaging, surgery)
• Treatment Outcome