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The Archives of Bone and Joint Surgery، جلد ۱۲، شماره ۲، صفحات ۱۰۸-۱۱۵
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عنوان انگلیسی Anatomic Reduction of Greater Tuberosity Fragment for Shoulder Hemiarthroplasty: a Predictor of Good Clinical Outcome
چکیده انگلیسی مقاله Objectives: Proximal humerus fractures account for four-five % of all fractures. Shoulder hemiarthroplasty is indicated for complex fractures with high complication rates when treated with ORIF. This study aims to evaluate the correlation between the proper intraoperative tuberosity reduction, and the mid-to-long-term clinical outcome in a series of patients treated with hemiarthroplasty after proximal humerus fracture.Methods: Forty-one patients with proximal humerus fractures who underwent hemiarthroplasty surgery between July 2009 and December 2019 were retrospectively reviewed. Quantitative analysis of the reduction of the tuberosities was performed on postoperative X-rays focusing on the distance between reconstructed greater tuberosity and the apex of the head of the prosthesis, (head-tuberosity distance), and contact between tuberosity and humerus diaphysis. The University of California Los Angeles Score (UCLA) was calculated for each patient.Results: The mean time to surgery was 6.29 ± 2.8 days (range 2-18 days). Nine patients out of 41 (22%) had non anatomic tuberosity, and 32 (78%) were anatomic reduced. The UCLA score at the final follow-up was good and excellent (≥27) in 27 patients (66%), and poor (<27) in 14 (34%). A significant correlation was observed between proper tuberosity reduction and good/excellent UCLA scores (P<0.001).Conclusion: Hemiarthroplasty is a valid and reliable technique for the treatment of proximal humerus fracture not eligible for internal fixation, with high risk of failure. The proper tuberosity reconstruction, paying special attention to the HTD and the contact between the cortical of the humeral diaphysis and the reconstructed tuberosity, is essential to reach a good clinical outcome. Level of evidence: IV
کلیدواژه‌های انگلیسی مقاله clinical outcome, Hemiarthroplasty, Proximal humerus fractures, shoulder, Tuberosities reduction
نویسندگان مقاله | Francesco Lazzarini
Department of Orthopaedic Surgery, Santa Maria Annunziata Hospital, Florence, Italy


| Marco Distefano
Department of Orthopaedic Surgery, Santa Maria Annunziata Hospital, Florence, Italy


| Tony Shen
Adult Reconstruction and joint Replacement, Hospital of Special Surgery, New York, NY, USA


| Gregorio Secci
Department of Shoulder Surgery, AOU Careggi, University Hospital of Florence, Florence, Italy


| Michael Cresci
Department of Shoulder Surgery, AOU Careggi, University Hospital of Florence, Florence, Italy


| Raffaele Tucci
Department of Shoulder Surgery, AOU Careggi, University Hospital of Florence, Florence, Italy


| Luigi Zanna
Department of Orthopaedic Surgery, Santa Maria Annunziata Hospital, Florence, Italy
نشانی اینترنتی https://abjs.mums.ac.ir/article_23673.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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