Hemiarthroplasty in Comminuted Fracture and Dislocation of the Proximal Humerus

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Journal of the Korean Shoulder and Elbow Society 1998;1(2):205-211.
Published online November 30, 1998.

Sung-Kwan Hwang, M.D. and Yong-Seok Kim, M.D.

Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea

상완골 근위부 분쇄성 골절 및 탈구에서 시행한 견관절 반치환술

황성관, 김용석

연세대학교 원주의과대학 정형외과학교실

Abstract

The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness

Key Words: Proximal humerus; Fracture and dislocation; Comminuted; Hemiarthroplasty

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