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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 11, 1407-1413.
doi: 10.1302/0301-620X.90B11.21070  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Early management of proximal humeral fractures with hemiarthroplasty

A SYSTEMATIC REVIEW

G. Kontakis, MD, Assistant Professor of Orthopaedics1; C. Koutras, MD, Fellow1; T. Tosounidis, MD, Resident in Orthopaedics1; and P. Giannoudis, MD, Professor of Orthopaedics2

1 Department of Orthopaedics and Trauma University Hospital of Heraklion, Crete, Greece 71110.
2 Department of Orthopaedics and Trauma University of Leeds, Great George Street, Leeds LS1 3EX, UK.

Correspondence should be sent to Dr G. Kontakis at; e-mail: gkontaki{at}yahoo.com

We performed a comprehensive systematic review of the literature to examine the role of hemiarthroplasty in the early management of fractures of the proximal humerus. In all, 16 studies dealing with 810 hemiarthroplasties in 808 patients with a mean age of 67.7 years (22 to 91) and a mean follow-up of 3.7 years (0.66 to 14) met the inclusion criteria. Most of the fractures were four-part fractures or fracture-dislocations.

Several types of prosthesis were used. Early passive movement on the day after surgery and active movement after union of the tuberosities at about six weeks was described in most cases. The mean active anterior elevation was to 105.7° (10° to 180°) and the mean abduction to 92.4° (15° to 170°). The incidence of superficial and deep infection was 1.55% and 0.64%, respectively. Complications related to the fixation and healing of the tuberosities were observed in 86 of 771 cases (11.15%). The estimated incidence of heterotopic ossification was 8.8% and that of proximal migration of the humeral head 6.8%. The mean Constant score was 56.63 (11 to 98). At the final follow-up, no pain or only mild pain was experienced by most patients, but marked limitation of function persisted.




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G. M. Kontakis, T. I. Tosounidis, Z. Christoforakis, and A. G. Hadjipavlou
Early management of complex proximal humeral fractures using the Aequalis fracture prosthesis: A TWO- TO FIVE-YEAR FOLLOW-UP REPORT
J Bone Joint Surg Br, October 1, 2009; 91-B(10): 1335 - 1340.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General