[Primary hemiarthroplasty of complex fractures of the humeral head - results for different prosthetic designs].
OBJECTIVE
Primary hemiarthroplasty of the shoulder is an alternative method for the treatment of complex fractures of the humeral head as compared to humeral head-preserving methods. This study compares the results of two different prosthetic designs. A first generation design, the Neer prosthesis (SGE 1 G) and a third generation design, the Aequalis prosthesis (SGE 3 G) were investigated.


METHODS
The data (patients' charts, X-ray, and ultrasound) were collected and analysed in a retrospective manner. Self assessment was performed using the visual analogue scale (VAS), functional outcome was determined using the Constant score. For data analysis, methods of descriptive statistic were applied.


RESULTS
29 patients were treated with the SGE 1 G and 49 patients were treated with the SGE 3 G. Patients' age in the mean was 76 years, more women than men were affected. According to the Neer fracture classification, four-part fractures were the most frequent type of fracture. 64 % of the patients in the Neer (SGE 1 G) group and 68 % in the Aequalis (SGE 3 G) group were satisfied with the result according to VAS. The average Constant score in the Neer group was 50 points and in the Aequalis group 59 points. Better results were detected for the subjective parameters pain and activity than for the objective parameters motion and strength. The postoperative deviation from the age- and sex-related Constant score was smaller in the Aequalis group (5 points) than in the Neer group (17 points). Ultrasound examinations revealed in nearly all patients atrophy of the rotator cuff resulting in disturbances of motion between the corresponding gliding tissues.


CONCLUSIONS
The SGE 3 G shows better results in the VAS and Constant score than the SGE 1 G. The advantages of the modular design of SGE 3 G are underlined by the clinical results.
Klinikum Schwäbisch Gmünd, Stauferklinik, Mutlangen.
G
G
Kelsch
G
G
Röderer
F
F
Gebhard
C
C
Ulrich
D000368:Aged; D000369:Aged, 80 and over; D001175:Arthrography; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000175:diagnosis / Q000601:surgery*; D014463:Ultrasonography