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THE ROLE OF ARTHROSCOPY IN SHOULDER FUNCTION RESTORATION AFTER PROXIMAL HUMERAL FRACTURE MALUNION

THE ROLE OF ARTHROSCOPY IN SHOULDER FUNCTION RESTORATION AFTER PROXIMAL HUMERAL FRACTURE MALUNION

George D. Tsikouris, MD, GREECE Ioannis K. Antonopoulos, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Dimosthenis Chrysikos, MD, MSc, PhD, GREECE Theodoros G. Troupis, Prof, GREECE

Athens Kolonaki Orthopeadics and Sports Medicine Center (AKOSMC), Athens, Attiki, GREECE


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

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Summary: Middle age adults with history of proximal humeral fracture malunion could be really benefited with shoulder arthroscopy.


Background

Proximal humerus fractures represent about 4-5% of all the fractures. Our aim is to evaluate the role of shoulder arthroscopy after proximal humeral fracture malunion.

Methods

In total, 14 athletes (5 females, 9 males) with mean age 43.1 years were included in our research that carried on from March 2012 to December 2021. Physical examination and imaging evaluation via 3D Computed Tomography (3D-CT), Magnetic Resonance Imaging (MRI) and shoulder radiographs (anteroposterior, internal rotation and lateral scapular view) were used to evaluate shoulder dysfunction after proximal humeral fracture malunion. Post-op, the clinical results were evaluated with Neer grade (displacement component), pain score (1-10) as reported by the patients, UCLA score and shoulder abduction ROM measured with a goniometer compared to the prior surgery ones.

Results

The follow-up period lasted 2.8 years on average (range 12-43 months) and the rate was 100%. 11 of 14(78%) patients had 1 part displaced and the rest 3(22%) had 2 parts displaced according to Neer classification before surgery. The mean pain score before surgery was 8 (range 6-9) and reduced to 4 (range 2-6) after surgery. The UCLA score showed an excellent outcome (p < 0.01) with an improvement from a mean 12 (range 9-16) points pre-operatively to 28 (range 20-31) points post-operatively. Shoulder abduction ROM increased from 80 (range 70-100) to 135 (range 120-150) before and after surgery respectively (p <0.05).

Conclusion

Middle age athletes with history of proximal humeral fracture malunion could be really benefited with shoulder arthroscopy concerning the pain level, ROM range and joint function restoration.


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