Prospective review of 43 elderly patients (mean age 78) treated with a Delta reverse shoulder prosthesis for displaced three- and four-part proximal humerus fractures. It asks whether the reverse design can deliver useful function in a population where tuberosity healing after hemiarthroplasty is unreliable.
The clinical decision rule: in an elderly patient with a displaced three- or four-part proximal humerus fracture and a poor-quality or cuff-deficient shoulder, reverse arthroplasty delivers deltoid-powered elevation that does not depend on tuberosity healing.
That matters because tuberosity malposition is the main reason hemiarthroplasty fails. Here, 53% of tuberosities displaced yet function held up, which is the whole biomechanical argument for the reverse design in this setting.
Expect trade-offs. External rotation stays weak when the greater tuberosity fails, and scapular notching (25%) and heterotopic ossification (90%) are common though usually low-consequence in low-demand patients. Read this as early evidence, not a mandate. The authors explicitly refuse to call it routine at 22-month follow-up, and glenoid loosening risk over time remains the unanswered question.
Reverse Shoulder Arthroplasty for the Treatment of Three- and Four-Part Fractures of the Proximal Humerus in the Elderly
Radiological Assessment of Osteo-Arthrosis.
Mesenchymal Stem Cells.
Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty. an End-Result Study Using a New Method of Result Evaluation.
Bone: Formation by Autoinduction.
Treatment of Deep Cartilage Defects in the Knee with Autologous Chondrocyte Transplantation.
Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity
Osteoclast Differentiation Factor Is a Ligand for Osteoprotegerin/osteoclastogenesis-Inhibitory Factor and Is Identical to Trance/rankl.
Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis. Vigor Study Group.
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Novel Regulators of Bone Formation: Molecular Clones and Activities.
The Diagnosis of Osteoporosis.
"modes of Failure" of Cemented Stem-Type Femoral Components: a Radiographic Analysis of Loosening.
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Prevention of Infection in the Treatment of One Thousand and Twenty-Five Open Fractures of Long Bones: Retrospective and Prospective Analyses.
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Vacuum-Assisted Closure: a New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.
A System for the Functional Evaluation of Reconstructive Procedures after Surgical Treatment of Tumors of the Musculoskeletal System.
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The Stabilizing System of the Spine. Part I. Function, Dysfunction, Adaptation, and Enhancement.
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Porosity of 3D Biomaterial Scaffolds and Osteogenesis.
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Clinician's Guide to Prevention and Treatment of Osteoporosis.
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Radiation Exposure from CT Scans in Childhood and Subsequent Risk of Leukaemia and Brain Tumours: a Retrospective Cohort Study.
Epidemiology of Adult Fractures: a Review.
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A Joint Coordinate System for the Clinical Description of Three-Dimensional Motions: Application to the Knee.
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Oarsi Guidelines for the Non-Surgical Management of Knee Osteoarthritis.
Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050.
Metastasis to Bone: Causes, Consequences and Therapeutic Opportunities.
Role of Proinflammatory Cytokines in the Pathophysiology of Osteoarthritis.
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Osteoporosis: Now and the Future.
Clinical Features of Metastatic Bone Disease and Risk of Skeletal Morbidity.
Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs. a 1:1:2 Ratio and Mortality in Patients with Severe Trauma: the Proppr Randomized Clinical Trial
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Prospective review of 43 elderly patients (mean age 78) treated with a Delta reverse shoulder prosthesis for displaced three- and four-part proximal humerus fractures. It asks whether the reverse design can deliver useful function in a population where tuberosity healing after hemiarthroplasty is unreliable.
The clinical decision rule: in an elderly patient with a displaced three- or four-part proximal humerus fracture and a poor-quality or cuff-deficient shoulder, reverse arthroplasty delivers deltoid-powered elevation that does not depend on tuberosity healing.
That matters because tuberosity malposition is the main reason hemiarthroplasty fails. Here, 53% of tuberosities displaced yet function held up, which is the whole biomechanical argument for the reverse design in this setting.
Expect trade-offs. External rotation stays weak when the greater tuberosity fails, and scapular notching (25%) and heterotopic ossification (90%) are common though usually low-consequence in low-demand patients. Read this as early evidence, not a mandate. The authors explicitly refuse to call it routine at 22-month follow-up, and glenoid loosening risk over time remains the unanswered question.