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Published on: July 5, 2011
Humeral Head Replacement in the Treatment of Comminuted Proximal Humeral Fracture
Xinghuo Zhang1, Yakui Zhang1, Tao Guo1
1Department of Bone and Joint Surgery and Sports Medicine of Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Insights
Artificial humeral head replacement effectively treats comminuted proximal humeral fractures. This procedure restores shoulder joint stability and function, with most patients achieving excellent or good outcomes.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Biomedical Engineering
Background:
- Comminuted proximal humeral fractures pose significant treatment challenges.
- Restoring shoulder joint stability and function is crucial for patient recovery.
Purpose of the Study:
- To evaluate the outcomes of artificial humeral head replacement in patients with comminuted proximal humeral fractures.
- To assess the efficacy and safety of this surgical intervention.
Main Methods:
- Retrospective study of 18 patients with comminuted proximal humeral fractures treated with humeral head replacement.
- Data collected included operation time, blood loss, Constant Functional Score, and complication rates.
- Follow-up duration averaged 4 years.
Main Results:
- The average operation time was 82 minutes, with an average blood loss of 210 mL.
- The mean Constant Functional Score was 83.5, with 14 patients achieving excellent/good results.
- No cases of joint dislocation, instability, or infection were reported; pre-existing nerve injuries showed recovery.
Conclusions:
- Artificial humeral head replacement is a viable treatment for comminuted proximal humeral fractures.
- The procedure effectively restructures the shoulder joint.
- Timely and appropriate rehabilitation is essential for optimal patient outcomes.
Objective:
To investigate the outcomes of humeral head replacement in the treatment of patients with comminuted proximal humeral fracture.
Methods:
Between February 2013 and September 2016, 56 patients underwent humeral head replacement in our hospital. Of them, 18 cases were diagnosed as comminuted proximal humeral fracture before the operation. The mean age of the patients was 69.5 years old (ranging from 61 to 79 years old). Of them, there were six males and 12 females. All the patients in this group had fresh fractures. They were all treated by artificial humeral head replacements. After the prosthesis was fixed by bone cement reliably, the greater or lesser trochanter and prosthesis handle were sutured and fixed firmly. The interval time from injury to operation ranged from 1 to 5 days. The Constant Functional Score, operation time, blood loss, nerve injury, joint dislocation rate, and infection rate were recorded at the final follow-up. The clinical data of these patients were retrospectively studied. All of the data were recorded in average form.
Results:
In this study, the mean duration of follow-up was 4 years, ranging from 3 to 6 years. The operation time ranged from 75 to 120 min, with the average of 82 min. The blood loss ranged from 100 to 400 mL, with the average of 210 mL. The mean score of Constant Functional Score was 83.5 ± 3.1. Of them, 14 cases achieved excellent and good (scores of more than 80), and four cases achieved moderate and poor (scores of less than 80). No patient suffered from joint dislocation, unstable joint, or infection after the operation. There were two patients with axillary nerve injury before the operation. However, the function could be recovered within 3-6 weeks after the surgery.
Conclusion:
The artificial humeral head replacement could be applied for the treatment of patients with comminuted proximal humeral fracture. During the surgery process, the stable structure of shoulder joint could be completely restructured, and the rehabilitation plan should be adjusted reasonably and timely after the operation.
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