title: Reverse total shoulder replacement for nonunion of a fracture of the proximal humerus.
abstract: Patients with pain and loss of shoulder function due to nonunion of a fracture of the proximal third of the humerus may benefit from reverse total shoulder replacement. This paper reports a prospective, multicentre study, involving three hospitals and three surgeons, of 35 patients (28 women, seven men) with a mean age of 69 years (46 to 83) who underwent a reverse total shoulder replacement for the treatment of nonunion of a fracture of the proximal humerus. Using Checchia's classification, nine nonunions were type I, eight as type II, 12 as type III and six as type IV. The mean follow-up was 51 months (24 to 99). Post-operatively, the patients had a significant decrease in pain (p < 0.001), and a significant improvement in flexion, abduction, external rotation and Constant score (p < 0.001), but not in internal rotation. A total of nine complications were recorded in seven patients: six dislocations, one glenoid loosening in a patient who had previously suffered dislocation, one transitory paresis of the axillary nerve and one infection. Reverse total shoulder replacement may lead to a significant reduction in pain, improvement in function and a high degree of satisfaction. However, the rate of complications, particularly dislocation, was high.
authors.affiliation: Instituto de Traumatología Cordobes, Arruzafilla Avenue S/N 14011, Córdoba, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Zafra
authors.affiliation: University Hospital Reina Sofía, Menendez Pidal Avenue, 14004, Córdoba, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Uceda
authors.affiliation: University Hospital Puerta del Mar, Ana de Viya avenue 21, 11009 Cádiz, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Flores
authors.affiliation: University Hospital Reina Sofia, Menendez Pidal Avenue, Cordoba, 14004, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Carpintero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011446:Prospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: Humeral nonunions; Treatment; Reverse Shoulder Arthroplasty