Abstract

ANTUNES, João; NASCIMENTO, Herculano  and  MIRANDA, António. Hemiartroplastia do ombro no tratamento de fraturas proximais do úmero. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.1, pp.40-49. ISSN 1646-2122.

Objective: A large proportion of proximal humeral fractures can be treated conservatively; however more complex fractures often require surgical treatment. The hemiarthroplasty (HA) is used in cases where the anatomical reduction of the fracture by internal fixation is not possible or when the vasculature of the humeral head has been compromised. The objective of this work is to present the casuistic of our Department and the clinical evaluation of patients undergoing HA fracture of the proximal humerus, with a minimum follow-up of 2 years. Methods: Between 2001 and 2011, were performed 59 HA for proximal humerus fracture, of which 45 patients were included. Retrospective analysis of clinical notes and clinical assessment of patients were performed. Statistical analysis of the variables through SPSSv20 software. Results: The 45 cases of patients receiving HA were reviewed, with an average follow up of 77 months. The average antepulsion was 88,6º and the average abduction 64,4º. The average values of the Constant score and ASES were, respectively, 47.0 and 49.3 points. There was at least one complication in 62% of patients. In these, the value of Constant was lower, with statistical significance (p = 0.024). 80% of patients report being satisfied or very satisfied with the results of surgery. Conclusions: HA is a valid option in the treatment of complex fractures of the proximal humerus, and pain relief is expected in most patients. However, obtaining good functional results is dependent on the correct reconstruction of the tuberosities. It is essential to perform a preoperative evaluation of the patient and of the characteristics of the fracture, to assist in choosing the best treatment option.

Keywords : Hemiarthroplasty; shoulder; proximal humeral fracture.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )