REVERSE SHOULDER PROSTHESIS IN TRAUMATHOLOGY. PRINCIPLES AND RESULTS
Abstract:
The reverse shoulder arthroplasty converts the glenoid into a spherical head and the head of the humerus into a socket, thus providing a stable fulcrum for glenohumeral joints with deficiency of the rotator cuff. The reverse prosthesis has become a treatment of choice for glenohumeral osteoarthritis in a cuff deficient shoulder. It allows restoration of mobility despite the loss of rotator cuff function. Hemiarthroplasty fails most commonly because of tuberosity nonunion in about 40 %. Therefore, in the face of poor bone quality, the reverse prosthesis is a logical choice for acute fractures to improve postoperative mobility in elevation regardless of tuberosity healing. Nevertheless, the healing of the tuberosities may influence the recovery in active external rotation. The purpose of this article is to report on the superolateral technique to implant a reverse shoulder prosthesis for acute proximal humeral fractures, emphasizing the technique of tuberosity fixation, and to analyze previously published series. Considering the follow-up and complication risks, the reverse prosthesis should be reserved for fractures involving elderly patients over 70 years old.
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