Document Detail


Management of proximal humerus fractures utilizing reverse total shoulder arthroplasty.
MedLine Citation:
PMID:  23334846     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The increased incidence of proximal humerus fractures has resulted in a thoughtful evolution of treatment options in order to optimize clinical outcomes. Complex three- and four-part fractures present a treatment challenge, particularly in elderly patients with significant medial comorbidities and poor bone quality. While open reduction and internal fixation is a reasonable surgical option in some patients with acceptable bone quality and simple fracture patterns that are not susceptible to avascular necrosis, shoulder hemiarthroplasty is a well-established procedure for many elderly patients (i.e., >70 years). Historically, hemiarthroplasty has provided reliable pain relief, but outcomes with regard to function, motion, and strength have varied. Ultimately, successful outcomes are dependent upon tuberosity healing, since an intact rotator cuff is required to restore function. With the advent of reverse total shoulder arthroplasty (RTSA) and increased familiarity with the surgical technique, successful outcomes have been achieved in older patients with poor potential for tuberosity healing. In this review, we discuss the recent role of RTSA in the setting of proximal humerus fractures, including surgical indications, preferred operative technique, and recent literature that supports its use.
Authors:
Kristofer J Jones; David M Dines; Lawrence Gulotta; Joshua S Dines
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current reviews in musculoskeletal medicine     Volume:  6     ISSN:  1935-973X     ISO Abbreviation:  Curr Rev Musculoskelet Med     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-14     Completed Date:  2013-02-15     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  101317803     Medline TA:  Curr Rev Musculoskelet Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-70     Citation Subset:  -    
Affiliation:
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA, kjjonesmd@gmail.com.
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