• 作者：L. Obert^a ; ^{lobert@chu-besancon.fr" class="auth_mail" title="E-mail the corresponding author} ; R. Saadnia^a ; C. Tournier^b ; N. Bonnevialle^c ; D. Saragaglia^d ; F. Sirveaux^e ; La SOFCOT^f
• 关键词：Fractures ; Proximal humerus ; Four-part fracture ; Multicenter study ; Reversed prosthesis ; Osteosuture ; Elderly patients
• 刊名：Orthopaedics & Traumatology: Surgery & Research
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：102
• 期：3
• 页码：279-285
• 全文大小：505 K

d="absSec_2">Material and methods

d="spar0010">The French Society of Orthopaedic and Traumatology Surgery (SOFCOT) conducted a prospective and retrospective multicenter study to evaluate the results of the reversed shoulder prosthesis implanted in patients with a four-part fracture in nine centers. In the retrospective study (n = 41 patients, 78 years of age, 14% ASA grade 3, 21% associated fractures) and in the prospective study (n = 32 patients, 79 years of age, 37% ASA grade 3, 21% associated fractures) evaluation by independent surgeons was conducted to measure the QuickDASH score, the Constant score, the SSV (subjective shoulder value), and complications to correlate these measurements with radiological results.

d="absSec_3">Results

d="spar0015">In both studies, use of an autograft (75%) to perform an osteosuture of tuberosities (90%) and no postoperative immobilization (75%) were similar. In the retrospective study at 39 months (range: 24–62 months) of follow-up, the QuickDASH reached 28 (range: 0–59), the Constant scores (raw Constant = 57, weighted Constant = 83.4%), and SSV 75 (range: 35–100). Complications after the 1st month (7%) were nonunion or ossifications. In the prospective study at 11 months (range: 5–16.5 months) of follow-up, the QuickDASH reached 40 (range: 1–75), the Constant scores 50 (raw Constant) and 74.6% (weighted Constant), and SSV 69 (range: 10–100). Complications after the 1st month (21%) were stiffness and dislocation, with two patients who underwent revision surgery. In both studies, early complications reached 6% (palsy, dislocation).

d="absSec_4">Conclusion

d="spar0020">This double (retrospective and prospective) study confirms the good results with a low level of complications of the reversed implant in cases of fracture but with osteosuture of tuberosities.