Morea Vincenzo, Polizzi Alberto, Niccoli Giuseppe, Zattoni Guido, Andriollo Luca
Orthopedics and Traumatology, Fondazione Poliambulanza Hospital, Brescia, ITA.
Department of Orthopedics, Università Cattolica del Sacro Cuore, Rome, ITA.
Cureus. 2024 Feb 15;16(2):e54276. doi: 10.7759/cureus.54276. eCollection 2024 Feb.
In trauma settings, including the management of outcomes, there is no consensus on the most appropriate reconstructive method in the presence of severe bone loss of the proximal humerus. The objective of this report is to evaluate the short-term functional outcomes of two patients in whom reverse shoulder megaprosthesis was used to treat the failure of trauma surgery with severe bone loss. The secondary objective was to compare the results obtained with the literature regarding the use of megaprosthesis in shoulder trauma surgery. The patients showed a satisfying functional recovery and increased quality of life. At the 12-month follow-up, no complications occurred. Regarding the risk of complications, especially the risks of mobilization of the megaprosthesis, the CT-based intraoperative navigation system optimizes the configuration of the screw for the initial fixation of the glenoid component. Shoulder megaprosthesis appears to be a viable option not only in oncologic surgery but also in cases of failed trauma surgery. The functional results, considering functional score and range of motion, are encouraging and allow patients to improve their quality of life.
在创伤治疗领域，包括对治疗结果的管理，对于存在严重肱骨近端骨缺损时最合适的重建方法尚无共识。本报告的目的是评估两名使用反向肩关节大假体治疗伴有严重骨缺损的创伤手术失败患者的短期功能结果。次要目的是将获得的结果与有关大假体在肩部创伤手术中应用的文献结果进行比较。患者显示出令人满意的功能恢复且生活质量提高。在12个月的随访中，未发生并发症。关于并发症风险，尤其是大假体松动的风险，基于CT的术中导航系统优化了用于肩胛盂部件初始固定的螺钉配置。肩关节大假体似乎不仅在肿瘤手术中，而且在创伤手术失败的病例中都是一种可行的选择。考虑到功能评分和活动范围，功能结果令人鼓舞，并使患者能够提高生活质量。
