Abstract
Objective: Analysis of the influence in shoulder function of restoring total humeral length (THL) in proximal humeral fractures (PHF) treated with hemiarthroplasty and comparing the data with a control group of proximal fractures treated with osteosynthesis.
Material and method: Prospective study involving 56 patients, twenty-nine 2 and 3 part PHF treated with osteosynthesis and twenty-seven 3 and 4 part fractures treated with hemiarthroplasty. Clinical assessment through Constant Score and radiological exam of the THL of both humerus as well as CT scans to analyze position of the tuberosities at 1-year follow-up.
Results: Osteosynthesis group: mean Constant Score of 77.37. In all cases greater tuberosity consolidated in good position. When differences in THL were higher than 2 cm Constant Score values significatively decreased to mean of 67, when ranging from 0 to 2 cm did not differ significatively from mean Constant Score.
Hemiarthroplasty group: mean Constant Score of 55.76. In 5 cases THL was increased (mean 0.87 cm) with a mean Constant Score of 63.5 and among them the greater tuberosity consolidated in place in 3 cases and posteriorly in 2. In 20 cases THL was decreased (mean 1.03 cm) with a mean Constant Score of 54.25 and among them if the difference was minor than 1 cm the greater tuberosity consolidated in place in 3 cases, consolidated posteriorly in 4 and absent in 1 case, and if the difference was greater than 1 cm, the greater tuberosity consolidated in place in 4 cases, consolidated posteriorly in 6 and absent in 2 cases . In 2 cases no differences in THL.
Conclusions: In PHF treated either with osteosynthesis or hemiarthroplasty, the greater tuberosity can be properly reattached if THL differences are less than 2 cm.
Constant Score correlates with greater tuberosity position at any difference of THL less than 2 cm.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
