RESULTS: At the last follow-up, the greater tuberosity was healed in an adequate (anatomic) position in 45% of the patients in group A (14 of 31) and 87% of those in group B (26 of 30) (P = .0001). Active forward elevation, active external rotation, and the Constant score were significantly better with fracture stems (136°, 34°, and 68 points, respectively) than with conventional stems (113°, 23°, and 58 points, respectively) (P < .0001). Regardless of the type of implant used, patients aged 75 years or older and women had significantly lower functional results and higher rates of tuberosity complications (P < .0001).
CONCLUSION: Good functional outcomes can be anticipated after hemiarthroplasty for proximal humeral fractures if the greater tuberosity is anatomically positioned (ie, lateral to the stem) and healed around the prosthesis. The use of a specific fracture stem allows to double the rate of tuberosity healing compared to a conventional stem (87% vs. 45%), decreases complications and improves shoulder function. Risk factors associated with poor functional results and anatomic failures are (1) patient age (≥75 years), (2) patient gender (women), and (3) use of a conventional (bulky) stem.
PMID: 23834993 [PubMed - as supplied by publisher]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23834993?dopt=Abstract
