J Korean Orthop Assoc.  2011 Apr;46(2):152-157.

Reverse Shoulder Arthroplasty for Humeral Head Fracture with Massive Rotator Cuff Tear in Elderly Patient

• Kwon OS
• Moon CY
• Kim WY

Abstract

There are several methods to treat anatomic neck fracture of humerus in elderly patients. It is not easy to obtain optimal clinical or radiological results because of unstable fixaton of fractured site attributed to multifractured osteoporotic tuberosities and combined massive rotator cuff tears in these patients. These factors often lead to high failure rate of implantation. Alternative methods of treatment have been proposed to reduce complications and improve shoulder functions. Reverse shoulder prosthesis was originally designed for patients with cuff tear arthropathy. Indications for reverse shoulder arthroplasty have expanded with initial success. However, there are few reports to perform reverse shoulder prosthesis in proximal humerus fracture. We performed reverse shoulder arthroplasty in a 74-year-old man with right anatomic neck fracture of humerus and concomitant massive rotator cuff tear.

Keyword

shoulder; anatomic neck fracture; massive rotator cuff tear; reverse prosthesis

MeSH Terms

Aged
Arthroplasty
Humans
Humeral Head
Humerus
Neck
Prostheses and Implants
Rotator Cuff
Shoulder

Figure

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  Figure 1 (A, B) Plain radiographs show displaced humeral head fracture, subacromial spur and reduced acromiohumeral interval.

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  Figure 2 CT scan demonstrates anteriorly displaced humeral head fragment and arthritic changes on glenoid.

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  Figure 3 (A, B) 3D CT reveales humerus head fracture with inferomedial displacement of fractured head fragment.

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  Figure 4 (A, B) MR images show full thickness rotator cuff tears with retraction and muscle atrophy.

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  Figure 5 (A, B) Plain radiographs taken 12 months after implantation of reverse shoulder prosthesis.

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  Figure 6 (A, B) This patient showed 150° forward elevation and 50° external rotation at side 12 months after surgery.

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