Abstract

ROSSI, Luciano A. et al. Influencia de la consolidación de las tuberosidades en los resultados clínicos de la prótesis invertida para fracturas de húmero proximal. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.4, pp.466-475. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.4.1487.

Objective: The objective of this study was to compare the clinical outcomes and complications of a consecutive series of patients with proximal humerus fractures (PHF) treated with reverse shoulder arthroplasty (RSA), with and without anatomical healing of the tuberosities. Materials and Methods: We evaluated 113 patients >65 years old with PHF treated with RSA. Seventy patients presented anatomical healing of the tuberosities and 43 presented absence of healing. Range of motion (ROM), Constant score, ASES score, visual analog scale (VAS) and the score of the numerical evaluation of single evaluation (SANE) were evaluated. Results: The mean follow-up was 56 months (range, 24-96 months) and the mean age was 73 years (range, 65-83 years). Mean postoperative active elevation and internal rotation were 131° (±14) and 27° (±5), respectively. The mean postoperative external rotation in abduction and adduction was 27° (±1) and 15° (±6) respectively. The mean postoperative VAS was 1.7 (±0.8). The mean ASES, Constant and SANE scores were 76 (±6), 62 (±11) and 74% (±7), respectively. Anterior elevation, external rotation, and final mean ASES and Constant functional scores were significantly better in the group with tuberosity healing than in the group without healing. Conclusions: In patients >65 years old with PHF treated with RSA, both postoperative ranges of motion and functional scores were significantly better in patients where anatomic tuberosity healing was achieved than in those where it was not achieved.

Keywords : Proximal humerus fracture; reverse arthroplasty; tuberosities reconstruction.

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