Reverse Shoulder Arthroplasty to Treat Proximal Humerus Fracture Sequelae: A Review

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomedical Engineering

Background:

• Nonsurgical treatment of proximal humerus fractures can lead to symptomatic malunions or nonunions.
• Joint-preserving repair options may be suboptimal due to poor bone stock or arthritis.
• Shoulder arthroplasty presents a viable alternative for complex fracture sequelae.

Purpose of the Study:

• To evaluate the efficacy of reverse shoulder arthroplasty for managing proximal humerus fracture sequelae.
• To highlight the role of reverse shoulder arthroplasty when conservative or joint-preserving methods are not feasible.
• To discuss the benefits of reverse shoulder arthroplasty in cases with bony deformity or rotator cuff deficiency.

Main Methods:

• Review of clinical studies demonstrating outcomes of reverse shoulder arthroplasty for proximal humerus fracture sequelae.
• Discussion of a classification system for predicting prognosis and complications.
• Emphasis on surgical pearls and pitfalls, including tuberosity management.

Main Results:

• Reverse shoulder arthroplasty shows reliable outcomes in managing proximal humerus fracture complications.
• The semiconstrained design is effective for improving function with bony deformity or rotator cuff tears.
• A classification system aids in predicting prognosis and potential complications.

Conclusions:

• Reverse shoulder arthroplasty is a powerful tool for managing symptomatic malunions and nonunions of proximal humerus fractures.
• It offers a solution when joint-preserving options are compromised by bone quality or arthritis.
• Careful surgical technique and understanding of potential pitfalls are crucial for successful outcomes.