REVERSE SHOULDER ARTHROPLASTY IN THE TREATMENT OF COMPLEX FRACTURES OF THE PROXIMAL HUMERUS IN THE ELDERLY. A PROSPECTIVE REVIEW OF 43 CASES WITH AN AVERAGE FOLLOW-UP OF 2 YEARS.

Introduction. The treatment of complex fractures of the proximal humerus still raises controversy, particularly in those 3 or 4 part fragments fractures, which are at risk for osteosynthesis (poor fixation in poor bone) or for secondary avascular necrosis. Conventional hemi-arthroplasty has currently remained the most common surgical treatment, but the recovery of active mobility remains incomplete and disappointing.Inverted shoulder arthroplasty has been initially proposed for the treatment of omarthrosis secondary to deficient rotatory cuffs, however its use in acute traumatology has not been yet investigated.Material and Medthod. We hereby present the results obtained in 43 consecutive patients (41 women and 2 men) which were retrospectively reviewed with a mean follow-up of 21 months (5–58). The mean age was 78 years-old (64–97). There were 5 three-part fractures, 26 four-part fractures and 12 four-part fracture dislocations. All patients were clinically and radiologically assessed, except two, who de...