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Modified hemiarthroplasty for four-part fractures of the proximal humerus.
MedLine Citation:
PMID:  22906147     Owner:  NLM     Status:  Publisher    
BACKGROUND: Hemiarthroplasty is used to treat patients with Neer four-part fractures but the post-operative complication rate remains high, particularly with regard to shoulder joint instability. This study was aimed at evaluating the efficacy of a modified rotator cuff reconstruction and balance technique by comparing it with conventional rotator cuff restoration surgery for Neer four-part fractures. METHODS: This retrospective therapeutic study included 67 patients with Neer four-part fractures. Forty-five patients underwent the modified surgery and 22 control patients underwent conventional surgery. All patients were followed up for more than 3 years. Outcome was assessed by grading clinical outcome and pain and strength, measuring range of motion, and radiographic analysis. RESULTS: The Neer score was higher in the modified surgery group (84 versus 75; P = 0.009). The rate of satisfaction (Neer score ≥80) in the modified surgery group was higher than in the conventional surgery group (71.11% versus 40.91%; P = 0.017). Range of motion for active abduction, external rotation, internal rotation and active forward elevation was greater in the modified surgery group (all P < 0.01). The morbidity rate of post-operative instability of the shoulder joint in the modified surgery group was much lower than that in the conventional surgery group (2.22% versus 18.2%; P < 0.01). CONCLUSION: The modified hemiarthroplasty procedure for treatment of Neer four-part fractures prevents post-operative instability of the shoulder joint and improves function of the shoulder more effectively than the conventional hemiarthroplasty procedure.
Xing Wu; Shao-Hua Li; Zheng-Dong Cai; Lie-Ming Lou
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-21
Journal Detail:
Title:  ANZ journal of surgery     Volume:  -     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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