Mid-term outcome of reverse shoulder prostheses in complex proximal humeral fractures.

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.