O2521 RELEVANCE OF THE ANATOMICAL RECONSTRUCTION TO THE FINAL OUTCOME IN HEMIARTHROPLASTY FOR HUMERAL HEAD FRACTURES

Abstract

Aims: The objective of this study was to assess whether anatomical placement of the prosthesis, in shoulder hemi-arthroplasty for fracture of the humeral head, is important to the clinical outcome. Methods: Sixteen patients, with a fracture of the upper humerus treated with hemi-arthroplasty, were followed-up 45.7±15.1 (20–72) months after surgery. The results were assessed using the Constant-Murley scale. The mean score was 75.8±15.7% (54–96%). At the time of their last follow up they underwent CT of the fractured and sound humerus, in order to be measured differences in humeral length and retroversion using special software. Correlation between these differences and the clinical outcome, as it was measured with the Constant-Murley scale, was performed. Results: The mean difference in retroversion was 8.7 degrees and the mean difference in length was 0.65cm, between fractured and sound humerus in our patients. We have achieved a very good þnal outcome (Constant score more than 71%) in patients with difference in retroversion less than 10 degrees and difference in length less then 14mm, between fractured and sound humerus. Conclusions: Restoration of the humeral length and retroversion is very important in shoulder hemiarthroplasty for fracture of the humeral head. Only small differences from the optimum length are well tolerated while only big differences from the optimum retroversion are likely to affect signiþcantly the clinical outcome. We attribute the very good clinical outcome in our series to the quality of the anatomical reconstruction that was performed despite the fact that our sample is small and we cannot have powerful statistics.