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The treatment of proximal humerus nonunions in older patients with the reverse shoulder arthroplasty.
MedLine Citation:
PMID:  22222366     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: The experience of the treatment of proximal humeral nonunions with the reverse total shoulder arthroplasty is limited. We report our results. PATIENTS: Eighteen patients with proximal humeral atrophic nonunion were treated with the reverse total shoulder prosthesis. There were 12 women and 6 men, with a mean age of 78.8 years (range, 75-84 years). The mean follow-up after the reverse arthorplasty was 28months (range, 24-32months). Extensive proximal humeral bone loss that was found in six cases was treated adding a proximal humeral allograft. A long humeral stem was always used. RESULTS: The mean constant score increased from 26% preoperatively to 55% postoperatively (p<0.0001). The average anterior elevation increased from 35° to 90° (p<0.0001), abduction from 35° to 85° (p<0.0001), external rotation from 15° to 30° (p<0.0001) and internal rotation from 25° to 55° (p<0.0001). The average subjective shoulder score increased from 10% preoperatively to 50% postoperatively (p<0.0001). All but 4 patients would undergo the same procedure again if faced with the same problem. Eight patients were very satisfied, 6 satisfied and 4 unhappy with the operation. We had one case of transitory axillary nerve palsy and two cases of infection. Two prosthetic dislocations occurred. They were successfully treated by revision with a larger polyethylene glenosphere of 44mm. CONCLUSIONS: The reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the rate of dislocation is high.
Authors:
Angel A Martinez; Carlos Bejarano; Ignacio Carbonel; Daniel Iglesias; Jorge Gil-Alvaroba; Antonio Herrera
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-3
Journal Detail:
Title:  Injury     Volume:  -     ISSN:  1879-0267     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Affiliation:
Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Zaragoza, Spain.
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