Treatment of proximal humerus fractures with shoulder prosthesis [Il trattamento delle fratture dell'omero prossimale con endoprotesi di spalla]

Aim. The aim of this study is to evaluate the clinical results of shoulder replacement after trauma, during a follow-up period. Methods. A retrospective analysis has been carried out on 20 patients operated at the 1st University Clinic and at the 1st Division of Orthopedics of the CTO Hospital in Turin between 1996 and 2002 (mean follow-up 31.5 months). The study took into consideration such aspects as work activity, trauma, type pf fracture, prosthesis, and complications. The patients were studied with the Constant score and the Simple Shoulder Test (SST). Results. The mean value of the total score is 46.3/100 (Pondered Constant: 63.3%). The variable strength is the one with the lower score. The results of SST confirm the results of the previous test; in fact, the two questions regarding the recovering of strength and external rotation showed a low rate of positive answers. Conclusion. The results obtained confirm the difficulties in treating proximal humerus fractures, and the unsatisfactory postoperative rehabilitation. However, it is suggested that shoulder replacement is still a good solution in most of the cases.