Abstract
The management of three or four-part fractures of proximal Humerus remains difficult. Controversy still persists concerning the preferred treatment of these fractures. The aim of our study was to review the functional outcome and factors influencing the outcome after shoulder hemi arthroplasty in acute fractures of proximal humerus.
Material and Methods: Retrospective review of a consecutive series of 23 patients with three/four-part proximal humerus fractures, treated with shoulder hemi-arthroplasty between 1999 – 2002. Nineteen patients (one bilateral) were available for study. The mean follow-up period was 12 months. All fractures, 16 cases were Neer’s four-part fractures, while one case was fracture with posterior dislocation. Post operative pain, range of motion and function evaluated using Visual analogue score, Pain scale and UCLA functional score. The average age was 64 years (range 50–85).
Results: At follow-up pain relief was satisfactory in 15 of 20 cases. Patient’s satisfaction was 75%. Functional evaluation was good/fair in 14 cases. One patient developed chronic inferior subluxation post-operatively. We have found that age (75 years +) at the time of surgery, securing of tuberosities t the implant and compliance with the post-operative rehabilitation program are significant factors affecting the outcome.
Conclusion: We recommend careful patient selection, proper positioning of patient during surgery, use of x-ray screening of the implant prior to cementing and meticulous surgical technique to achieve optimal results.
The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
