title: Outcome after primary and secondary hemiarthroplasty in elderly patients with fractures of the proximal humerus.
abstract: Thirty-nine consecutive patients with 3- and 4-part proximal humeral fractures and fracture dislocations were treated with hemiarthroplasty. After an average of 42 months (range 5 to 98 months) of follow-up, 17 women and 8 men (average age 64.5 years) were evaluated with the University of California-Los Angeles (UCLA) scale, the Constant-Murley scale, the Hospital for Special Surgery (HSS) scale, and the visual analogue scale. Fair, good, or excellent results were achieved in 80% of the patients on the UCLA and Visual scales, in 72% of the patients on the HSS scale, and in 44% of the patients on the Constant-Murley scale. The highest correlation was between the HSS score and the Visual analogue score. According to the UCLA and Constant-Murley results, the outcome after early (<4 weeks) humeral head replacement was significantly better than after late (> or =4 weeks) humeral head replacement (UCLA score, P=.02; Constant-Murley score, P=.01). After early hemiarthroplasty active forward flexion was significantly better (P=.035). Thus the decision to perform prosthetic humeral head replacement in elderly patients should be made as early as possible after trauma.
authors.affiliation: Department of Traumasurgery, Hannover Medical School, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Bosch
authors.forename: M
authors.initials: M
authors.lastname: Skutek
authors.forename: R W
authors.initials: RW
authors.lastname: Fremerey
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D012784:Shoulder Fractures / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome