title: Medium-term results after primary hemiarthroplasty for comminute proximal humerus fractures: a study of 46 patients followed up for an average of 4.4 years.
abstract: This study investigated 82 patients who underwent primary hemiarthroplasty for a severely displaced proximal humerus fracture at Danderyd Hospital between 1989 and 2002. According to the Neer classification system, fractures were 2-part in 2, 3-part in 20, and 4-part in 60. The prostheses used were 12 Neer-II, 39 Global, and 31 Bigliani-Flatow. Follow-up time averaged 4.4 years (range, 1-14 years). Twenty-two patients died, 9 were contacted by phone, and 5 were lost to follow-up. Forty-six patients underwent clinical examination, including the Constant score (CS) and radiographic examination. Mean CS for all patients was 42 of 100 points (range, 11-83 points). Radiologic evaluation revealed that 24 prostheses had migrated superiorly; this finding decreased the CS significantly. Ectopic bone developed in 25 patients, 16 had glenoid erosion, and 5 had displaced tuberosities; no correlation was found with the CS. Hemiarthroplasty usually prevented shoulder pain, but most patients had moderate function and poor strength. The reduced function appeared to be related to a lack of rotator cuff integrity.
authors.affiliation: Division of Orthopaedics, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. carina.gronhagen@ds.se
authors.forename: Carina M
authors.initials: CM
authors.lastname: Grönhagen
authors.forename: Hassan
authors.initials: H
authors.lastname: Abbaszadegan
authors.forename: Suzanne A
authors.initials: SA
authors.lastname: Révay
authors.forename: Per Y
authors.initials: PY
authors.lastname: Adolphson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010146:Pain; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D016896:Treatment Outcome