Matsuzawa Gaku, Hatta Taku, Aizawa Toshitake
Department of Orthopaedic Surgery, Iwaki City Medical Center, Iwaki, JPN.
Department of Orthopaedic Surgery, Tome Citizen Hospital, Tome, JPN.
Cureus. 2024 Nov 6;16(11):e73166. doi: 10.7759/cureus.73166. eCollection 2024 Nov.
Simultaneous bilateral proximal humerus fractures (PHFs) are infrequent. Particularly rare are cases of PHFs extending to the metadiaphysis accompanied by severe osteoarthritis (OA) of the shoulder. To our knowledge, there have been no reports of bilateral fractures that include metadiaphyseal fractures with severe OA on one side and a PHF on the contralateral side, treated with bilateral reverse shoulder arthroplasty (RSA). We present a case of an 84-year-old woman with a right humeral metadiaphyseal fracture with severe OA and a left proximal humeral fracture, both treated with bilateral RSA. The surgical technique for the humerus metadiaphyseal fracture involved adjusting soft-tissue tension for RSA, where the proximal bone fragment was opened and wrapped around the humeral component. The clinical outcomes of this case suggest that this surgical technique can be a viable option to restore function in rare cases of humeral metadiaphyseal fractures with severe OA of the shoulder and simultaneous contralateral proximal humeral fractures.
双侧肱骨近端骨折(PHFs)并不常见。尤其罕见的是肱骨近端骨折延伸至骨干中段并伴有严重肩关节骨关节炎(OA)的病例。据我们所知,尚无关于一侧为伴有严重OA的骨干中段骨折而另一侧为PHF的双侧骨折采用双侧反肩关节置换术(RSA)治疗的报道。我们报告一例84岁女性患者,其右侧肱骨骨干中段骨折伴严重OA,左侧肱骨近端骨折,均采用双侧RSA治疗。肱骨骨干中段骨折的手术技术包括为RSA调整软组织张力,将近端骨块打开并包裹在肱骨假体周围。该病例的临床结果表明,对于罕见的伴有严重肩关节OA的肱骨骨干中段骨折及对侧同时存在的肱骨近端骨折,这种手术技术可能是恢复功能的可行选择。