title: Hemiarthroplasty versus reverse shoulder arthroplasty: comparative study of functional and radiological outcomes in the treatment of acute proximal humerus fracture.
abstract: OBJECTIVE
  To compare functional and radiographic results of reverse prosthesis versus hemiarthroplasty after complex displaced proximal humeral fractures in elderly patients when adequate ORIF cannot be achieved and prosthetic shoulder replacement is required.
  
  
  METHODS
  From 2008 to 2012, 67 patients were treated with hemiarthroplasty or reverse arthroplasty. We evaluated 53 cases with an average follow-up of 27.5 months (range 12-64). Twenty-eight patients with an average age of 71.4 years were treated with a hemiarthroplasty and 25 patients with an average age of 77.3 years with a reverse prosthesis. All patients were assessed before and after surgery by Constant-ASES-DASH score, strength in abduction, ER1, ER2, and X-rays.
  
  
  RESULTS
  In hemiarthroplasty group, we observed a mean Constant score of 42.3 pt, ASES score 51.3 pt, and DASH score 46.1, with an average strength of 1.3 lb in abduction and of 3.7 lb in ER1 and 1.8 lb in ER2. In reverse arthroplasty group, we measured a mean Constant of 56.2 pt, ASES 69.3 pt, and DASH score 40.4, with an average strength of 4.3 lb in abduction and of 3.3 lb in ER1 and 3.2 lb in ER2. Radiographically, it is interesting to observe that greater tuberosity healing rate was 37 % in hemiarthroplasty group compared to 84 % in reverse arthroplasty group. About complications, the highest rate was recorded in the hemiarthroplasty group.
  
  
  CONCLUSIONS
  Reverse shoulder arthroplasty indication is steadily increasing in acute displaced proximal humeral fracture. Pain and articular movement results appear better than those with hemiarthroplasty. Our data are similar to the international literature.
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy. baudi.paolo@policlinico.mo.it.
authors.forename: P
authors.initials: P
authors.lastname: Baudi
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Campochiaro
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Serafini
authors.affiliation: Department of Orthopaedic Surgery, Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gazzotti
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Matino
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Rovesta
authors.affiliation: Department of Orthopaedic Surgery, Policlinico Modena University, Via del Pozzo 71, 41100, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catani
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000379:methods; D006801:Humans; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hemiarthroplasty; Reverse shoulder arthroplasty; humeral proximal fracture