title: Reverse shoulder arthroplasty for complex fractures of the proximal humerus in elderly patients: impact on the level of independency, early function, and pain medication.
abstract: BACKGROUND
  This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus.
  
  
  METHODS
  This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014.
  
  
  RESULTS
  Level of independency, quality of life (Short Form 36 Health Survey score), early functional outcome (Constant-Murley score, Disabilities of the Arm, Shoulder and Hand Outcome Measure), and pain medication (World Health Organization grading) were obtained at the 6-month follow-up and 1 year after surgery. The Constant-Murley score was 64 ± 14 after 6 months and 71 ± 12 at 1 year (P < .001), reaching 87% compared with the contralateral shoulder. The Disabilities of the Arm, Shoulder and Hand score reached 29 ± 20 at 6 months and 30 ± 21 at 1 year. The Short Form 36 score was comparable to normative data. After 6 months, 84% of our study group were back at their previous level of independency. Within 1 year, this rate increased to 91%. At the 1-year follow-up, analgesia intake was back at the level before the injury in 97% of the patients.
  
  
  CONCLUSIONS
  Primary RSA provides good early functional results, reliable pain control, and excellent restoration of an independent life style in elderly patients. Thus, RSA may be considered for active patients with a high demand on shoulder function.
authors.affiliation: Department of Surgery, Zuger Kantonsspital, Baar, Switzerland. Electronic address: fwolfi@gmx.ch.
authors.forename: Fabian
authors.initials: F
authors.lastname: Wolfensperger
authors.affiliation: Department of Surgery, Stadtspital Waid, Zürich, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Grüninger
authors.affiliation: Department of Surgery, Stadtspital Waid, Zürich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Dietrich
authors.affiliation: Department of Orthopedics, Kantonsspital Frauenfeld, Frauenfeld, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Völlink
authors.affiliation: Department of Orthopedics and Traumatology, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Benninger
authors.affiliation: Department of Orthopedics and Traumatology, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Schläppi
authors.affiliation: Department of Orthopedics and Traumatology, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Meier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D059408:Pain Management; D011446:Prospective Studies; D011788:Quality of Life; D012784:Shoulder Fractures / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology* / Q000601:surgery*; D020069:Shoulder Pain / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: CMS; DASH; RSA; Reverse shoulder arthroplasty; level of independence; outcome; proximal humeral fracture