Shoulder hemiarthroplasty for fractures of the proximal humerus

Proximal humeral fractures were managed with primary hemiarthroplasty in 57 patients, 53 women (93%) and 4 men (7%) aged 51–87 years (mean 72.2). The mean follow-up period was 52 months (range 12–98), and the mean Constant score was 59.2 (range 38–76). Patients were very satisfied (n = 19); satisfied (n = 32) or dissatisfied with the outcome (n = 5). One patient required early revision surgery. Surgical treatment of three- and four-part fractures of the proximal humerus with hemiarthroplasty is a safe and effective approach, the outcome of which appears to be related to the quality of the anatomical reconstruction of the tuberosities

Avaliação funcional retrospectiva de pacientes com fratura proximal de úmero fixada com placa com parafusos de ângulo fixo para região proximal no úmero Retrospective functional assessment of patients with humerus proximal fractures internally fixed with a fixed-angle plate for proximal humerus area

As fraturas do úmero proximal são lesões comuns, levando seus pacientes a importantes limitações funcionais além de algumas complicações. Atualmente existem algumas opções de tratamentos cirúrgicos visando à melhor estabilização da lesão através de técnicas de ostessíntese, dependendo do grau de gravidade da lesão. Dentre eles, tem-se utilizado a placa com parafusos de ângulo fixo para região proximal do úmero, a qual possui o intuito de preservar a integridade biológica da cabeça umeral associada à redução anatômica segura utilizando múltiplos parafusos de fixação com estabilidade angular, permitindo assim a mobilização precoce do membro fraturado. Foram estudados retrospectivamente 11 pacientes com fratura proximal do úmero, tratados com esse modelo de placa entre os anos de 2004 e 2005. Na avaliação funcional foram utilizados o questionário de Constant e o índice DASH. Os resultados sugerem o aparecimento de perda funcional residual no membro superior após esse tipo de trauma, apesar da fixação estável e o tratamento fisioterapêutico.<br>Proximal humeral fractures are common injuries leading to severe functional restrictions and complications for patients. Today, there are several surgical alternatives aimed at achieving better injury stabilization by means of osteosynthesis techniques, depending on injury severity. One of these is the fixed-angle plate fixation of the proximal humerus. This bone fixation system is intended to preserve the biologic integrity of the humeral head associated with a safe anatomical reduction, employing several fixating screws with angle stability, thereby allowing an early mobilization of the fractured limb. Eleven patients with proximal humeral fractures treated with the method of fixed-angle plate fixation of the proximal humerus in the period of 2004 to 2005 were retrospectively studied. The patients were subjected to the Constant questionnaire and the DASH index for functional assessment. The results showed some residual dysfunction at the upper end after this type of trauma, even using a fixed-angle plate fixation of the proximal humerus, which notably provides a safe fixation, associated to physical therapy