Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures

Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of...

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Main Authors: A. Panagopoulos, P. Tsoumpos, K. Evangelou, Christos Georgiou, I. Triantafillopoulos
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2013/403580
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author A. Panagopoulos
P. Tsoumpos
K. Evangelou
Christos Georgiou
I. Triantafillopoulos
author_facet A. Panagopoulos
P. Tsoumpos
K. Evangelou
Christos Georgiou
I. Triantafillopoulos
author_sort A. Panagopoulos
collection DOAJ
description Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN) and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.
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spelling doaj-art-e2c748416df14ee3b369a2a8c247ac9d2025-08-20T02:21:14ZengWileyAdvances in Orthopedics2090-34642090-34722013-01-01201310.1155/2013/403580403580Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral FracturesA. Panagopoulos0P. Tsoumpos1K. Evangelou2Christos Georgiou3I. Triantafillopoulos4Department of Shoulder & Elbow Surgery, Orthopaedic Clinic, University Hospital of Patras, Papanikolaou 1, 26504 Patras, GreeceDepartment of Shoulder & Elbow Surgery, Orthopaedic Clinic, University Hospital of Patras, Papanikolaou 1, 26504 Patras, GreeceDepartment of Shoulder & Elbow Surgery, Orthopaedic Clinic, University Hospital of Patras, Papanikolaou 1, 26504 Patras, GreeceDepartment of Shoulder & Elbow Surgery, Orthopaedic Clinic, University Hospital of Patras, Papanikolaou 1, 26504 Patras, GreeceDepartment of Shoulder & Elbow Surgery, Metropolitan Hospital Athens, Medical School, University of Athens, Ethnarxou Makariou & El. Benizelou 1, N. Faliro, 18547 Piraeus, GreeceBackground. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN) and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.http://dx.doi.org/10.1155/2013/403580
spellingShingle A. Panagopoulos
P. Tsoumpos
K. Evangelou
Christos Georgiou
I. Triantafillopoulos
Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
Advances in Orthopedics
title Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
title_full Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
title_fullStr Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
title_full_unstemmed Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
title_short Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures
title_sort late prosthetic shoulder hemiarthroplasty after failed management of complex proximal humeral fractures
url http://dx.doi.org/10.1155/2013/403580
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