title: Anatomic and reverse shoulder prostheses in fracture sequelae of the humeral head.
abstract: OBJECTIVE
  Arthroplasty for the proximal humerus problems secondary to fractures is troublesome, because of necrosis of the tubercles and the resulting insufficiency of the rotator cuff. The aim of this study was to investigate whether better results can be achieved with the differential use of anatomic and reverse shoulder prostheses, in comparison to the preoperative status.
  
  
  METHODS
  Fifty-five patients with secondary fracture prostheses due to sequelae of fractures of the humeral head were followed. Anatomic prostheses were implanted in 36 cases (fracture sequelae types 1 and 2 according to Boileau), and reversed prostheses were implanted in 19 cases (fracture sequelae types 3 and 4).
  
  
  RESULTS
  The mean scores of the patients improved from 19 to 68 points (anatomic prosthesis) for fracture sequelae types 1 and 2, and from 9 to 47.5 points (reverse prosthesis) for fracture sequelae types 3 and 4.
  
  
  CONCLUSIONS
  The differential use of anatomic and reversed shoulder prostheses in secondary fracture treatment leads to an improvement in postoperative results. In fracture sequelae types 1 and 2, the anatomic prosthesis is a better choice. However, in fracture sequelae types 3 and 4 with severe deformities, the reversed prosthesis is clearly superior to the anatomic prosthesis.
authors.affiliation: Marienstift Arnstadt, Department of Orthopedic Surgery, Arnstadt, Germany.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kılıç
authors.forename: Alexander
authors.initials: A
authors.lastname: Berth
authors.forename: Georges
authors.initials: G
authors.lastname: Blatter
authors.forename: Uwe
authors.initials: U
authors.lastname: Fuhrmann
authors.forename: Katja
authors.initials: K
authors.lastname: Gebhardt
authors.forename: Olaf
authors.initials: O
authors.lastname: Rott
authors.forename: Peter
authors.initials: P
authors.lastname: Zenz
authors.forename: Ulrich
authors.initials: U
authors.lastname: Irlenbusch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000844:Ankylosis; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010003:Osteoarthritis / Q000601:surgery; D011474:Prosthesis Design; D011859:Radiography; D017006:Rotator Cuff / Q000473:pathology; D012784:Shoulder Fractures / Q000145:classification / Q000150:complications / Q000601:surgery*; D012785:Shoulder Joint / Q000473:pathology