Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures

Chung Hee Oh; Joo Han Oh; Sae Hoon Kim; Ki Hyun Jo; Sung Woo Bin; Hyun Sik Gong

doi:10.12671/jkfs.2008.21.3.213

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Oh, Oh, Kim, Jo, Bin, and Gong: Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures

Original Article

Journal of the Korean Fracture Society 2008; 21(3): 213-219.

Published online: 31 July 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.3.213

Hemiarthoplasty with Bone Block Graft and Low Profile Prosthesis for the Comminuted Proximal Humerus Fractures

Chung Hee Oh, M.D., Joo Han Oh, M.D., Ph.D., Sae Hoon Kim, M.D., Ki Hyun Jo, M.D., Sung Woo Bin, M.D., Hyun Sik Gong, M.D., Ph.D.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Address reprint requests to: Joo Han Oh, M.D. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. Tel: 82-31-787-7197, Fax: 82-31-787-4056, ojhysy@snubh.org

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the outcome of hemiarthroplasty with bone block graft and low profile prosthesis (Aequalis® fracture prosthesis) for the comminuted proximal humerus fractures.

Materials and Methods

Sixteen low profile prostheses were used since July 2004, and 11 patients were followed-up for average 19.9 (12~30) months. Their mean age was 67.3 (52~78) years. Pain and satisfaction visual analog scale (VAS), range of motion, and modified UCLA score for hemiarthroplasty were evaluated at every visit. Radiography was also checked for stem position, loosening, and tuberosity union.

Results

Mean pain VAS was 2.7 (0~5), and mean satisfaction VAS was 8.4 (5~10). Mean active forward flexion was 137° (90~170), external rotation at side was 45.5° (25~70), and internal rotation at back was T10 (T7~L1). Modified UCLA score was 19 (12~30) at final visit. All stems were stable, and there were no loosening at the final follow-up. All tuberosities were united except two tuberosity absorptions.

Conclusion

The outcome of hemiarthroplasty with bone block graft and low profile prosthesis was comparable to other implants for comminuted proximal humerus fractures. This system had unique advantages for tuberosity union. Further study with more patients and longer follow-up are necessary to clarify the effectiveness of this prosthesis.

Keywords: Proximal humerus fracture, Hemiarthroplasty, Bone block graft, Low profile prosthesis

Figures and Tables

Fig. 1

(A) Initial radiography and (B) 3D-CT scan of right shoulder of 60 year old female shows the four part fracture of the proximal humerus. (C, D) Photographs depict the range of motion of patient at 1 year after the hemiarthroplasty with bone block graft and low profile prosthesis. Her forward elevation was 170 degrees, external rotation at side was 70 degrees, and internal rotation at back was T7 level. Her pain VAS was 4, and satisfaction VAS was 10. (E) Anteroposterior and (F) axial view of radiographies at 2 years 6 months after surgery illustrate the stable prosthesis without loosening. Prosthetic head position from the greater tuberosity and glenoid looked appropriate.

Table 1

Modified UCLA scoring system for hemiarthroplasty

Table 2

Comparison of clinical outcomes according to age

^*One patient of delayed infection was excluded from the statistics.

^*Every item exhibited no significant relationship between two groups except modified UCLA score (p<0.05).

Table 3

Comparison of clinical outcomes according to gender

^*One patient of delayed infection was excluded from the statistics.

^*Every item exhibited no significant relationship between two groups (p>0.05).

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