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Modified hemiarthroplasty for four‐part fractures of the proximal humerus
Author(s) -
Wu Xing,
Li ShaoHua,
Cai ZhengDong,
Lou LieMing
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06178.x
Subject(s) - medicine , surgery , rotator cuff , range of motion , shoulder joint , external rotation , patient satisfaction , retrospective cohort study , radiography , humerus
Background Hemiarthroplasty is used to treat patients with N eer four‐part fractures but the post‐operative complication rate remains high, particularly with regard to shoulder joint instability. This study was aimed at evaluating the efficacy of a modified rotator cuff reconstruction and balance technique by comparing it with conventional rotator cuff restoration surgery for N eer four‐part fractures. Methods This retrospective therapeutic study included 67 patients with N eer four‐part fractures. Forty‐five patients underwent the modified surgery and 22 control patients underwent conventional surgery. All patients were followed up for more than 3 years. Outcome was assessed by grading clinical outcome and pain and strength, measuring range of motion, and radiographic analysis. Results The N eer score was higher in the modified surgery group (84 versus 75; P = 0.009). The rate of satisfaction ( N eer score ≥80) in the modified surgery group was higher than in the conventional surgery group (71.11% versus 40.91%; P = 0.017). Range of motion for active abduction, external rotation, internal rotation and active forward elevation was greater in the modified surgery group (all P < 0.01). The morbidity rate of post‐operative instability of the shoulder joint in the modified surgery group was much lower than that in the conventional surgery group (2.22% versus 18.2%; P < 0.01). Conclusion The modified hemiarthroplasty procedure for treatment of N eer four‐part fractures prevents post‐operative instability of the shoulder joint and improves function of the shoulder more effectively than the conventional hemiarthroplasty procedure.