Four-part proximal humerus fractures treated with osteosynthesis and reverse shoulder arthroplasty: mid-term results
- 作者: Egiazaryan K.A.1, Ershov D.S.1, Tychina E.P.1, Mikhailov I.I.1, Kondyrev N.M.1
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隶属关系:
- Pirogov Russian National Research Medical University
- 期: 卷 31, 编号 4 (2025)
- 页面: 66-75
- 栏目: Clinical studies
- URL: https://journal-vniispk.ru/2311-2905/article/view/357894
- DOI: https://doi.org/10.17816/2311-2905-17722
- ID: 357894
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Background. Four-part fractures of the proximal humerus (PHF) present great difficulties in selecting an appropriate treatment method.
The aim of the study — to compare the mid-term clinical outcomes of surgical treatment in patients with four-part fractures of the surgical neck of the humerus after uncomplicated osteosynthesis and arthroplasty, using the results of a newly developed subjective outcome assessment system.
Methods. The retrospective study included patients aged 18 to 90 years with four-part fractures and fracture-dislocations of the proximal humerus, with injury duration of up to 14 days. Patients were divided into two groups: the osteosynthesis group (O, n = 23) and the arthroplasty group (A, n = 25). In both groups, 12 months after the surgery, we conducted a survey using a specially developed subjective assessment system.
Results. No significant difference was found between the groups in the subjective assessment of treatment outcomes one year after osteosynthesis of PHF and reverse shoulder arthroplasty. However, in patients from both groups, different criteria were identified as more significant in subjective assessment of the fracture treatment outcome. In A group, following criteria were significant: restricted range of motion in the upper limb and the percentage of functional recovery of the upper limb. In O group, the most prognostically important criteria for treatment assessment were the VAS point and the patients’ self-assessment of their contribution to the rehabilitation of the operated arm after surgery.
Conclusion. In four-part fractures of the proximal humerus, plate osteosynthesis can be expected to yield treatment outcomes comparable to those of reverse shoulder arthroplasty. Our study highlights the importance of subjective assessment of quality of life and patient satisfaction, which have become key components in clinical decision-making in the treatment of four-part fractures of the proximal humerus.
作者简介
Karen Egiazaryan
Pirogov Russian National Research Medical University
Email: egkar@mail.ru
ORCID iD: 0000-0002-6680-9334
SPIN 代码: 5488-5307
Dr. Sci. (Med.), Professor
俄罗斯联邦, MoscowDmitry Ershov
Pirogov Russian National Research Medical University
编辑信件的主要联系方式.
Email: ershov0808@gmail.com
ORCID iD: 0000-0001-7005-2752
SPIN 代码: 9839-1206
Cand. Sci. (Med.), Associate Professor
俄罗斯联邦, MoscowEkaterina Tychina
Pirogov Russian National Research Medical University
Email: ekaterinn.ty@gmail.com
ORCID iD: 0009-0006-9697-672X
SPIN 代码: 6678-0152
俄罗斯联邦, Moscow
Ivan Mikhailov
Pirogov Russian National Research Medical University
Email: mikhailov.ivan01@gmail.com
ORCID iD: 0000-0003-1153-000X
俄罗斯联邦, Moscow
Nikolaj Kondyrev
Pirogov Russian National Research Medical University
Email: nkondyrev@gmail.com
ORCID iD: 0000-0001-8002-0260
俄罗斯联邦, Moscow
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