| The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture |
| Chang Meen Sung, Se Hyun Cho, Soon Taek Jung, Sun Chul Hwang, Hyung Bin Park |
| Department of Orthopaedic Surgery, School of Medicine, Gyeongsang National University, Jinju, Korea. hbinpark@nongae.gsnu.ac.kr |
| 요골두 금속 치환물의 국내 사용 |
| 한상환·문준규*·박종웅·장기모 |
| 고려대학교 의과대학 정형외과학교실 |
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| Abstract |
Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months.
Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years (range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score.
Results
The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2(6~10), 6.6(2~8), and 6.9(4~8). The total UCLA score was an average of 21.7(12~26). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1.
Conclusion
Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily. |
| Key Words:
Proximal humerus; Comminuted Fracture; Hemiarthroplasty |
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