title: A new prosthetic design for proximal humeral fractures: reconstructing the glenohumeral unit.
abstract: A new shoulder prosthesis design for proximal humeral fractures has been developed. The rim of the articular component of this prosthesis has several holes to which the bone-tendon junction of the rotator cuff is fixed, to allow an anatomic reconstruction of the glenohumeral unit. The strength of the tuberosity fixation to this prosthesis is investigated in a cadaveric study. Artificial 4-part fractures were created in 18 human, fresh-frozen, paired shoulder joints with intact rotator cuffs. Two methods of tuberosity fixation were used in a matched-pair fashion. In group I the tuberosities were sutured to the rim of the prosthetic head, and in group II the tuberosities were circumferentially tension band-wired. Strength testing was performed on a material-testing machine, and displacement was recorded with an opto-electronic device. Both fixation methods proved to be equally reliable in the forces exerted during activities of daily living without significant displacement of the fracture fragments.
authors.affiliation: Department of Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium. lieven.dewilde@rug.ac.be
authors.forename: Lieven F
authors.initials: LF
authors.lastname: De Wilde
authors.forename: Bart M
authors.initials: BM
authors.lastname: Berghs
authors.forename: Thomas
authors.initials: T
authors.lastname: Beutler
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ferguson
authors.forename: René C
authors.initials: RC
authors.lastname: Verdonk
mesh_terms: D000368:Aged; D002102:Cadaver; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D013536:Suture Techniques