Patients with pain and loss of shoulder function
due to nonunion of a fracture of the proximal third of the humerus may
benefit from reverse total shoulder replacement. This paper reports
a prospective, multicentre study, involving three hospitals and
three surgeons, of 35 patients (28 women, seven men) with a mean
age of 69 years (46 to 83) who underwent a reverse total shoulder
replacement for the treatment of nonunion of a fracture of the proximal humerus.
Using Checchia’s classification, nine nonunions were type I, eight
as type II, 12 as type III and six as type IV. The mean follow-up
was 51 months (24 to 99). Post-operatively, the patients had a significant
decrease in pain (p <
0.001), and a significant improvement in
flexion, abduction, external rotation and Constant score (p <
0.001), but not in internal rotation. A total of nine complications
were recorded in seven patients: six dislocations, one glenoid loosening
in a patient who had previously suffered dislocation, one transitory
paresis of the axillary nerve and one infection. Reverse total shoulder replacement may lead to a significant
reduction in pain, improvement in function and a high degree of
satisfaction. However, the rate of complications, particularly dislocation,
was high. Cite this article:
