Complications of the shoulder arthroplasty in patients with inveterate fractures and fracture- dislocations of the proximal humerus

Abstract

Purpose – to analyze сomplications after the shoulder arthroplasty in patients with inveterate fractures and fracture-dislocations of the proximal humerus. Materials and Methods. 69 patients with inveterate fractures and fracture-dislocations of the proximal humerus underwent surgery. The fractures were accompanied by posttraumatic plexopathy in 89% of cases. The following methods of studying were used: clinical, radiological, MRI, MSCT, ENMG of the shoulder girdle. Hemiarthroplasty was performed in 51 patients, bipolar arthroplasty in 10 patients, and total arthroplasty – in 8 ones. The outcomes of treatment were available in 54 patients within the periods from 6 months to 9.5 years after surgery. Results. Complications after the surgery were observed in 16 patients (29.6%). Brachial plexopathy accompanied the fractures in all these patients. The following complications were the most significant: implant head migration (16.6%) and implant instability (5.5%). Conclusion. The decrease in the number of complications after the shoulder arthroplasty for inveterate fractures in this area can be achieved by early prosthetics of the patients with fresh fractures, as well as by therapy of accompanying plexopathies simultaneously with treating the shoulder bone injuries.