J Korean Fract Soc.  2008 Jul;21(3):213-219. 10.12671/jkfs.2008.21.3.213.

Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures

• Oh CH
• Oh JH
• Kim SH
• Jo KH
• Bin SW
• Gong HS

• KMID: 2015444
• DOI: http://doi.org/10.12671/jkfs.2008.21.3.213

Abstract

PURPOSE: To evaluate the outcome of hemiarthroplasty with bone block graft and low profile prosthesis (Aequalis(R) fracture prosthesis) for the comminuted proximal humerus fractures.
MATERIALS AND METHODS
Sixteen low profile prostheses were used since July 2004, and 11 patients were followed-up for average 19.9 (12~30) months. Their mean age was 67.3 (52~78) years. Pain and satisfaction visual analog scale (VAS), range of motion, and modified UCLA score for hemiarthroplasty were evaluated at every visit. Radiography was also checked for stem position, loosening, and tuberosity union.
RESULTS
Mean pain VAS was 2.7 (0~5), and mean satisfaction VAS was 8.4 (5~10). Mean active forward flexion was 137 degrees (90~170), external rotation at side was 45.5 degrees (25~70), and internal rotation at back was T10 (T7~L1). Modified UCLA score was 19 (12~30) at final visit. All stems were stable, and there were no loosening at the final follow-up. All tuberosities were united except two tuberosity absorptions.
CONCLUSION
The outcome of hemiarthroplasty with bone block graft and low profile prosthesis was comparable to other implants for comminuted proximal humerus fractures. This system had unique advantages for tuberosity union. Further study with more patients and longer follow-up are necessary to clarify the effectiveness of this prosthesis.

Keyword

Proximal humerus fracture; Hemiarthroplasty; Bone block graft; Low profile prosthesis

MeSH Terms

Follow-Up Studies
Hemiarthroplasty
Humans
Humerus
Prostheses and Implants
Range of Motion, Articular
Transplants

Figure

• 

  Fig. 1 (A) Initial radiography and (B) 3D-CT scan of right shoulder of 60 year old female shows the four part fracture of the proximal humerus. (C, D) Photographs depict the range of motion of patient at 1 year after the hemiarthroplasty with bone block graft and low profile prosthesis. Her forward elevation was 170 degrees, external rotation at side was 70 degrees, and internal rotation at back was T7 level. Her pain VAS was 4, and satisfaction VAS was 10. (E) Anteroposterior and (F) axial view of radiographies at 2 years 6 months after surgery illustrate the stable prosthesis without loosening. Prosthetic head position from the greater tuberosity and glenoid looked appropriate.

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