Valenti Philippe, Katz Denis, Kilinc Alexandre, Elkholti Kamil, Gasiunas Vytautas
Institut de la Main, Clinique Jouvenet, Paris, France.
Acta Orthop Belg. 2012 Aug;78(4):442-9.
The functional outcome of hemiarthroplasty in displaced proximal humeral 3- and 4-part fractures or fracture dislocations in elderly patients is frequently unpredictable and depends on the position of the prosthesis and tuberosity fixation. Reverse shoulder arthroplasty represents an alternative in elderly patients. The purpose of this study was to report the results of a retrospective series of 30 reverse shoulder prostheses in trauma indications. We also compared the results of a less medialized reverse shoulder prosthesis (Arrow) with those reported for the traditional (Delta III) reverse prosthesis. Twenty seven cases were available for analysis. The mean follow-up was 22.5 months. The mean absolute Constant score was 54.9, the score for pain was 13.5, for activities 14, for strength 4.59. The mean active anterior elevation was 112 degrees, abduction 97 degrees, external rotation with the arm at the side: 12.7 degrees, in abduction: 55 degrees. Radiographs revealed no loosening, no glenoid notching. Reverse shoulder prosthesis may be a good alternative for displaced three- and four-part proximal humeral fractures in selected patients. The functional results are more predictable than with hemiarthroplasty in elderly patients.
老年患者移位的肱骨近端三部分和四部分骨折或骨折脱位行半关节成形术的功能结果往往不可预测，且取决于假体位置和结节固定情况。反肩关节置换术是老年患者的一种替代选择。本研究的目的是报告一组30例创伤适应证的反肩关节假体的回顾性研究结果。我们还比较了一种较不向内侧放置的反肩关节假体（Arrow）与传统（Delta III）反肩关节假体的报告结果。27例可供分析。平均随访时间为22.5个月。Constant平均绝对评分为54.9，疼痛评分为13.5，活动评分为14，力量评分为4.59。主动前屈平均为112度，外展为97度，手臂在体侧时的外旋为12.7度，外展时为55度。X线片显示无松动，无肩胛盂切迹。对于选定患者，反肩关节假体可能是移位的肱骨近端三部分和四部分骨折的良好替代选择。与老年患者行半关节成形术相比，其功能结果更可预测。
