FUNCTIONAL OUTCOMES OF REVERSE TOTAL SHOULDER ARTHROPLASTY IN ACUTE PROXIMAL HUMERAL FRACTURES VERSUS POST-TRAUMATIC SEQUELAE

Proximal humeral fractures account for 4–6 % of all fractures and are the third most prevalent fracture pattern in the elderly. Reverse total shoulder arthroplasty (RTSA) is a frequently utilized surgical procedure for treating this fracture. Aim. To improve the functional outcome and quality of life of patients with acute proximal humeral fractures and post-traumatic sequelae using reverse total shoulder arthroplasty. Subjects and Methods. This comparative study was conducted on a total of 20 patients with 3- or 4-part proximal humeral fractures aged more than 55 years, 10 patients were suffering from acute fractures (group I) and 10 patients with post-traumatic sequelae (group II). All patients were evaluated preoperatively and followed up postoperatively at 6 weeks, 3 months, 6 months and one year for functional outcomes. Radiological, clinical and functional outcomes were assessed by a goniometric range of motion (ROM), Constant-Murley score, and the Arabic version of the Quick DASH score. The rate of postoperative complications and the need for revision surgery were also reported. Results. In group I, the DASH and VAS score declined from 88.30 (± 8.23) and 5.90 (± 1.28) in the 6th weeks after surgery down to 34.30 (± 11.55) and 0.70 (± 0.48), respectively after 1 year. The Constant score increased from 14.70 (± 5.67) to 67.30 (± 14.98). All scores showed almost similar improvements in all three parameters in group II. Moreover, similar improvements in the deltoid muscle power, function and ranges of motion were reported in patients of both groups. Conclusion. Reverse shoulder arthroplasty provides favorable post-operative outcomes among elderly patients with 3-part and 4-part fractures of the proximal humerus. Indication for RTSA will not be affected by whether patients are presenting with acute or post-traumatic sequelae fractures. Level of evidence: Therapeutic study level III.