title: Cementless anatomical prosthesis for the treatment of 3-part and 4-part proximal humerus fractures: cadaver study and prospective clinical study with minimum 2 years followup.
abstract: BACKGROUND
  The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem for 3- and 4-part proximal humeral fractures.
  
  
  METHODS
  This study consisted of two parts: a cadaver study with 22 shoulders and a multicenter prospective clinical study of 23 fracture patients evaluated at least 2 years after treatment. In the cadaver study, the locked stem (Humelock(TM), FX Solutions) and its instrumentation were evaluated. In the clinical study, five senior surgeons at four different hospitals performed the surgical procedures. An independent surgeon evaluated the patients using clinical (Constant score, QuickDASH) and radiological (X-rays, CT scans) outcome measures.
  
  
  RESULTS
  The cadaver study allowed us to validate the height landmarks relative to the pectoralis major tendon. In the clinical study, at the review, abduction was 95° (60-160), forward flexion was 108° (70-160), external rotation (elbow at body) was 34° (0-55), the QuickDASH was 31 (4.5-59), the overall Constant score was 54 (27-75), and the weighted Constant score was 76 (31.5-109).
  
  
  CONCLUSIONS
  This preliminary study of hemiarthroplasty (HA) with a locked stem found results that were at least equivalent to published series. As all patients had at least a 2-year follow-up, integration of the locked stem did not cause any specific complications. These results suggest that it is possible to avoid using cement when hemiarthroplasty is performed for the humeral stem. This implant makes height adjustment and transosseous suturing of the tuberosities more reproducible.
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Obert
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: Rachid
authors.initials: R
authors.lastname: Saadnia
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Loisel
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Uhring
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Adam
authors.affiliation: Orthopaedic, Traumatology and Hand Surgery Unit, Research Unit: EA 4268 I4S - IFR 133 INSERM, CHRU Besançon, University of Bourgogne Franche-Comté, Bd Fleming, 25030 Besançon Cedex, France.
authors.forename: Séverin
authors.initials: S
authors.lastname: Rochet
authors.affiliation: Clinique Convert, 01000 Bourg en Bresse, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Clappaz
authors.affiliation: Orthopedic, Traumatology, and Hand Surgery Unit, Hopital Princesse Grace de Monaco, Monaco, Principauté de Monaco.
authors.forename: Tristan
authors.initials: T
authors.lastname: Lascar