title: [Primary shoulder arthroplasty for treatment of complex proximal humeral fractures with the trabecular metal prosthesis].
abstract: OBJECTIVE
  To evaluate the clinical results of primary shoulder arthroplasty for the treatment of complex proximal humeral fractures with the trabecular  metal prosthesis.
  
  
  METHODS
  In the study, 57 consecutive patients with complex proximal humeral fractures underwent primary shoulder arthroplasty with  the trabecular metal prosthesis, of whom 45 patients were available for the final follow-up (78.9%), and were retrospectively assessed. There were 15 men  and 30 women with the average age of (64.9±10.6) years (range: 45 to 85 years), and 14 left shoulders and 31 right shoulders were involved. The mean time  from injury to surgery was (10.2±4.8) days. According to Neer's classification, there were 3 patients with a three-part fracture, 4 with a three-part  dislocation, 2 with a four-part fracture, 22 with a four-part dislocation, 4 with a four-part valgus-impaction, and 10 with a head splitting. Thirty-nine  patients were treated with hemiarthroplasty, and the rest with total shoulder arthroplasty.
  
  
  RESULTS
  After a mean follow-up time of (18.7±8.1) months  (range: 12 to 41 months), the average range of motion of patients were 130.4°±36.5° for forward elevation, 37.6°±16.6° for external rotation and L3 level (±3  vertebrae) for internal rotation. The average VAS pain score, ASES score, Constant-Murley score and UCLA score were 0.5±1.2 (0-4), 81.4±13.9 (43-100),  81.6±13.6 (52-100) and 28.5±5.1 (16-35), respectively. The average patient satisfaction rate was 95.6%. The greater tuberosity healed anatomically in 42  patients, which was confirmed by the postoperative radiographs, while the greater tuberosity nonunion was found in the other three patients. Superior  migration of humeral head was found in two patients. There were no complications, such as infection, prosthetic loosening or neurovascular injury, related  to the surgery.
  
  
  CONCLUSIONS
  Primary shoulder arthroplasty for complex proximal humeral fractures with the trabecular metal prosthesis could yield good  clinical results. The healing rate of the greater tuberosity was 93.3%.
authors.affiliation: Department of Sports Medicine, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Feng-long
authors.initials: FL
authors.lastname: Li
authors.forename: Chun-yan
authors.initials: CY
authors.lastname: Jiang
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.forename: Yi-ming
authors.initials: YM
authors.lastname: Zhu
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.forename: Guan
authors.initials: G
authors.lastname: Wu
mesh_terms: 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*; D007595:Joint Prosthesis; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design / Q000379:methods; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*
chemical_list: D008670:Metals