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Primary Hemiarthroplasty for Proximal Humeral Fractures in the Elderly: Long-Term Functional Outcome and Social Implications

Dietrich, Michael ; Meier, Christoph ; Zeller, Daniela ; Grueninger, Patrick ; Berbig, Roger ; Platz, Andreas

In: European Journal of Trauma and Emergency Surgery, 2007, vol. 33, no. 5, p. 512-519

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    Titre
    • Primary Hemiarthroplasty for Proximal Humeral Fractures in the Elderly: Long-Term Functional Outcome and Social Implications
    Auteur
    • Dietrich, Michael. Department of Surgery, Stadtspital Triemli, Zurich, Switzerland
    • Meier, Christoph. Division of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland
    • Zeller, Daniela. Department of Surgery, Stadtspital Triemli, Zurich, Switzerland
    • Grueninger, Patrick. Department of Surgery, Stadtspital Triemli, Zurich, Switzerland
    • Berbig, Roger. SportClinic Zurich, Zurich, Switzerland
    • Platz, Andreas. Department of Surgery, Stadtspital Triemli, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Trauma and Emergency Surgery, 2007, vol. 33, no. 5, p. 512-519. Urban & Vogel
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320985
    Summary
    Background:: Primary shoulder hemiarthroplasty is an established treatment modality for complex fractures of the proximal humerus. Long-term functional outcome is often disappointing. However, little is known about social implications particularly in the elderly. Methods:: A single-institution case series of consecutive geriatric patients (age > 70 years) treated with shoulder hemiarthroplasty for complex fractures of the proximal humerus between 1994 and 1997 was analysed. Postoperative morbidity, long-term function, radiological outcome and social implications were evaluated. Results:: Seventy-seven patients fulfilled the study criteria. Median age at the time of operation was 80 years (range 70-93 years). Systemic and local postoperative complications were observed in 8% including 2 patients (3%) with revision surgery. Postoperative mortality was 1%. Forty-eight patients (62%) were available for follow-up (median 49 months, range 25-80 months), 22 (29%) died from causes unrelated to hemiarthroplasty before follow-up and 7 patients (9%) did not attend follow-up examination. Median Constant-Murley score was 41 points (range 17-77 points). Long-term results concerning pain were satisfying. The Oxford shoulder score ranged from 14 to 40 (median 30). Forty-one patients (85%) still lived in their original environment and managed their daily life independently despite poor shoulder function. Four patients (8%) lived in a retirement home and 3 (6%) in a nursery home. Eighty percent of our patients were still able to use public transportation, do the daily shopping and wash their whole body by themselves. Conclusion:: Most patients managed their daily life independently despite poor shoulder function