Resultados funcionales y radiográficos de la prótesis reversa y la reinserción del troquíter en pacientes con fracturas de húmero proximal

  • Juan Martín Patiño Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Carlos E. Martínez Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Bernardo Andres Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Francisco López Bustos Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • César Ruiz Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Hernán Fiminella Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Julio Ferro Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina
  • Alberto Garay Equipo de Cirugía de Mano y Miembro Superior, Instituto Dupuytren, Ciudad Autónoma de Buenos Aires, Argentina

Abstract

Objective: To report functional and radiologic outcomes of reverse shoulder arthroplasty (RSA) in patients with complex proximal humeral fractures. A second objective was to assess the relation between the greater tuberosity healing and the range of motion (ROM) and the American Shoulder and Elbow Surgeons (ASES) score. Materials and Methods: Sixteen patients treated between 2013 and 2017, older than 65 years old, operated before 4 weeks after the trauma, and with a minimum of 2-year follow-up were included. ASES scores and active ROMs were recorded. Greater tuberosity and the prosthesis position and healing were radiologically evaluated, and the complications and treatment were recorded. Results: The median age was of 74.5 years (IQR 66-78.5), 11 patients were females (69%). According to Neer classification, 11 cases were four-part fractures and 5 were four-part fracture-dislocations. The average time between trauma and surgery was 9.4 days, and the average follow-up was of 29.5 months. The greater tuberosity was healed in 9 cases (56%). Internal rotation: 5 patients (31.25%) were able to reach up with their thumbs to gluteal level, 4 (25%) to T12, 3 (18.75%) to T7, and 4 (25%) to L3. The medians for external rotation and forward flexion were 30° (IQR 17.5°-40°) and 100° (IQR 87.5°-160°). The average ASES score was of 78.3 (IQR 63.3-87.4). There was no significant statistical relation between greater tuberosity healing and forward flexion or ASES score (P=0.24 and P=0.52, respectively). Conclusion: The use of reverse prostheses for complex fractures with greater tuberosity reattachment could lead to good functional outcomes, low complication rates and reoperations. There was no significant statistical relation between ASES score and greater tuberosity healing or failure to heal.

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Published
2020-10-07
How to Cite
Patiño, J. M., Martínez, C. E., Andres, B., López Bustos, F., Ruiz, C., Fiminella, H., Ferro, J., & Garay, A. (2020). Resultados funcionales y radiográficos de la prótesis reversa y la reinserción del troquíter en pacientes con fracturas de húmero proximal . Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(2). Retrieved from https://raaot.org.ar/index.php/AAOTMAG/article/view/1273
Issue
Vol 85 No 2 (2020)
Section
Clinical Research

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