title: The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus.
abstract: BACKGROUND
  Experience treating proximal humerus fracture sequelae with reverse total shoulder arthroplasty is limited. We report our results.
  
  
  METHODS
  Forty-four patients with sequelae of a proximal humeral fracture were treated with a reverse total shoulder prosthesis. There were 26 women and 18 men, with a mean age of 77 years (range, 74-84 years). The mean follow-up after reverse arthroplasty was 48 months (range, 40-84 months).
  
  
  RESULTS
  The mean Constant score increased from 28 preoperatively to 58 postoperatively (p < 0.0001). The average anterior elevation increased from 40° to 100° (p < 0.0001), abduction from 41° to 95° (p < 0.0001), external rotation from 15° to 35° (p < 0.0001) and internal rotation from 25° to 60° (p < 0.0001). The average subjective shoulder score increased from 13% preoperatively to 56% postoperatively (p < 0.0001). All but six patients would undergo the same procedure again if faced with the same problem. Twenty-four patients were very satisfied, 14 satisfied and 6 unhappy with the operation. Six prosthetic dislocations occurred (13.6%). Two of them were successfully treated by adding an extension to the humeral neck component to increase the offset and tension. In the other four dislocations this procedure failed, and the prosthesis was revised and converted to a hemiarthroplasty. There was one case of glenoid component loosening that was converted to a hemiarthroplasty.
  
  
  CONCLUSIONS
  The reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the dislocation rate is high.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, C/Calamita s/n, Avda. Juan Pablo II 48, Zaragoza, Spain. anmarti67@yahoo.es
authors.forename: Angel Antonio
authors.initials: AA
authors.lastname: Martinez
authors.forename: Angel
authors.initials: A
authors.lastname: Calvo
authors.forename: Carlos
authors.initials: C
authors.lastname: Bejarano
authors.forename: Ignacio
authors.initials: I
authors.lastname: Carbonel
authors.forename: Antonio
authors.initials: A
authors.lastname: Herrera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome