Reverse Shoulder Arthroplasty with Latissimus Dorsi Transfer for Humerus Fractures Sequelae

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Relevance. Fractures of the proximal humerus occupy the 3rd place in the structure of fractures in the elderly. Failure to treat these injuries leads to irreversible changes in the shoulder. The main treatment for the latter is arthroplasty. The surgical treatment of this category of patients is still a difficult task. The purpose of this study was to compare the effectiveness of standard reverse arthroplasty with reverse arthroplasty in combination with the reconstruction of the external rotators of the shoulder or transposition of the latissimus dorsi. Materials and Methods. The retrospective evaluation of treatment results of 96 patients with consequences of shoulder injuries was conducted. Of these, 51 patients underwent standard reverse arthroplasty (group I), and 45 patients (group II) underwent arthroplasty with reconstruction of the external rotators of the shoulder or transposition of the latissimus dorsi. The female patients accounted for 68.8%. The duration of the injury varied from 8 months to 2.5 years, the follow-up — from 1 to 7 years (Me = 3.5). The results were assessed with VAS, ASES, UCLA scales. Results. The positive outcomes were observed in most patients. Complications: dislocations of the endoprosthesis occurred in 16.7%, infectious complications — in 5.2%, shoulder component instability — in 2.1%, fracture of the humeral diaphysis — in 3.1%, neurovascular bundle injury — in 2.1% of cases. In the patients of group I, dislocations occurred significantly more often than in the patients of group II. To reduce the risk of complications, a rational tactic has been developed for treating patients with consequences of shoulder injuries. If electroneuromyography values from the deltoid muscle were less than 40% of the contralateral side, or if mineral bone density T-score was less than 2.5 SD, arthroplasty was not performed. During arthroplasty, it is necessary to perform the direct suturing of the of the infraspinatus and teres minor tendons to the humerus. If it is impossible, the latissimus dorsi transfer is indicated. Conclusion. Reverse arthroplasty in the treatment of the humerus fractures sequelae is an effective technique. To reduce the risk of complications, it is necessary to provide the additional stability of the endoprosthesis by reconstruction of the external rotators or latissimus dorsi transfer. It is advisable to refrain from arthroplasty in cases of severe deltoid hypotrophy and severe osteoporosis.

作者简介

N. Chirkov

Federal Center of Traumatology, Orthopedics and Arthroplasty; Chuvash State University named after I.N. Ulyanov

编辑信件的主要联系方式.
Email: surgenik@gmail.com
ORCID iD: 0000-0001-7099-2672

Nikolai N. Chirkov — Cand. Sci. (Med.), Orthopedic Surgeon, Federal Center of Traumatology, Orthopedics and Arthroplasty; Assistant of Department of Traumatology, Orthopedics and Emergency Medicine, Chuvash State University named after I.N. Ulyanov

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N. Nikolaev

Federal Center of Traumatology, Orthopedics and Arthroplasty; Chuvash State University named after I.N. Ulyanov

Email: fake@neicon.ru
ORCID iD: 0000-0002-1560-470X

Nikolai S. Nikolaev — Dr. Sci. (Med.), Professor, Chief Physician of Federal Center of Traumatology, Orthopedics and Arthroplasty; Head of Department of Traumatology, Orthopedics and Emergency Medicine, Chuvash State University named after I.N. Ulyanov

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A. Kaminskii

Ilizarov National Medical Research Center for Traumatology and Orthopedics

Email: fake@neicon.ru
ORCID iD: 0000-0001-8647-4044

Andrei V. Kaminskii — Cand. Sci. (Med.), Head of the Traumatology and Orthopedic Department

Kurgan

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O. Spiridonova

Federal Center of Traumatology, Orthopedics and Arthroplasty

Email: fake@neicon.ru
ORCID iD: 0000-0002-3871-4223

Ol’ga V. Spiridonova — Physiotherapy Doctor

Cheboksary

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参考

  1. Егиазарян К.А., Ратьев А.П., гордиенко Д.И., григорьевА.В.,Овчаренко Н.В.Среднесрочные результаты лечения переломов проксимального отдела плечевой кости методом внутрикостного остеосинтеза. Травматология и ортопедия России. 2018;24(4):81-88. doi: 10.21823/2311-2905-2018-24-4-81-88.
  2. Cooper C., Cole Z.A., Holroyd C.R., Earl S.C., Harvey N.C., Dennison E.M. et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011;22(5):1277-1288. doi: 10.1007/s00198-011-1601-6.
  3. Gwinner C., Greiner S., Gerhardt C., Scheibel M. [Reverse shoulder arthroplasty for fracture sequelae]. Orthopade. 2013;42(7):531-541. (In German). doi: 10.1007/s00132-012-2024-6.
  4. Mansat P., Guity M.R., Bellumore y., Mansat M. Shoulder arthroplasty for late sequelae of proximal humeral fractures. J Shoulder Elbow Surg. 2004;13(3):305-312. doi: 10.1016/j.jse.2004.01.020.
  5. Wang J., Zhu y., Zhang F., Chen W., Tian y., Zhang y. Meta-analysis suggests that reverse shoulder arthroplasty in proximal humerus fractures is a better option than hemiarthroplasty in the elderly. Int Orthop. 2016;40(3):531-539. doi: 10.1007/s00264-015-2811-x.
  6. Zafra M., Uceda P., Flores M., Carpintero P. Reverse total shoulder replacement for nonunion of a fracture of the proximal humerus. Bone Joint J. 2014;96-B(9):1239-1243. doi: 10.1302/0301-620x.96B9.33157.
  7. Монастырев В.В., Пономаренко Н.С., Михайлов И.Н., Бальжинимаев Д.Б. Диагностика и лечение пациентов с переломом проксимального отдела плечевой кости. Сибирский медицинский журнал (Иркутск). 2018;154(3):66-71.
  8. Boileau P., Trojani C., Walch G., Krishnan S.G., Romeo A., Sinnerton R.J. Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg. 2001;10(4):299-308. doi: 10.1067/mse.2001.115985.
  9. Wall B., Nové-Josserand L., O’Connor D.P., Edwards T.B., Walch G. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am. 2007;89(7):1476-1485. doi: 10.2106/JBJS.F.00666.
  10. Hattrup S.J., Waldrop R., Sanchez-Sotelo J. Reverse Total Shoulder Arthroplasty for Posttraumatic Sequelae. J Orthop Trauma. 2016;30(2):e41-47. https://doi.org/10.1097/BOT.0000000000000416.
  11. Pastor M.F., Kieckbusch M., Kaufmann M., Ettinger M., Wellmann M., Smith T. Reverse shoulder arthroplasty for fracture sequelae: Clinical outcome and prognostic factors. J Orthop Sci. 2019;24(2):237-242. doi: 10.1016/j.jos.2018.09.016.
  12. Holton J., yousri T., Arealis G., Levy O. The Role of Reverse Shoulder Arthroplasty in Management of Proximal Humerus Fractures with Fracture Sequelae: A Systematic Review of the Literature. Orthop Rev (Pavia). 2017;9(1):6977. https://doi.org/10.4081/or.2017.6977. eCollection 2017 Feb 20.
  13. Hasty E.K., Jernigan E.W. 3rd, Soo A., Varkey D.T., Kamath G.V. Trends in Surgical Management and Costs for Operative Treatment of Proximal Humerus Fractures in the Elderly. Orthopedics. 2017;40(4):e641-e647. doi: 10.3928/01477447-20170411-03.
  14. Puvanesarajah V., Shafiq B., Ingari J.V. Glenohumeral Arthrodesis With Reamer-Irrigator-Aspirator (RIA) Bone Grafting After Traumatic Proximal Humerus Bone Loss and Flail Shoulder. Tech Hand Up Extrem Surg. 2019;23(3): 128-132. doi: 10.1097/BTH.0000000000000226.
  15. Sebastia-Forcada E., Lizaur-Utrilla A., Cebrian-Gomez R., Miralles-Muñoz F.A., Lopez-Prats F.A.J. Outcomes of Reverse Total Shoulder Arthroplasty for Proximal Humeral Fractures: Primary Arthroplasty Versus Secondary Arthroplasty After Failed Proximal Humeral Locking Plate Fixation. Orthop Trauma. 2017;31(8):e236-e240. doi: 10.1097/BOT.0000000000000858.
  16. Vincent H.K., Struk A.M., Reed A. Wright T.W. Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients. Springerplus. 2016;5(1):1929. doi: 10.1186/s40064-016-3624-0.
  17. Antuña S.A., Sperling J.W., Sánchez-Sotelo J., Cofield RH.J. Shoulder arthroplasty for proximal humeral malunions: long-term results. J Shoulder Elbow Surg. 2002;11(2):122-129. doi: 10,1067/mse.2002.120913.
  18. Visser C.P., Coene L.N., Brand R., Tavy D.L. Nerve lesions in proximal humeral fractures. J Shoulder Elbow Surg. 2001;10(5):421-427. doi: 10.1067/mse.2001.118002.
  19. Pastor M.F., Kraemer M., Wellmann M., Hurschler C., Smith T. Anterior stability of the reverse shoulder arthroplasty depending on implant configuration and rotator cuff condition. Arch Orthop Trauma Surg. 2016;136(11):1513-1519. doi: 10.1007/s00402-016-2560-3.
  20. Chae J., Siljander M., Wiater J.M. Instability in Reverse Total Shoulder Arthroplasty. J Am Acad Orthop Surg. 2018;26(17):587-596. doi: 10.5435/JAAOS-D-16-00408.
  21. Cheung E.V., Sarkissian E.J., Sox-Harris A., Comer G.C., Saleh J.R., Diaz R., Costouros J.G. Instability after reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2018;27(11):1946-1952. doi: 10.1016/j.jse.2018.04.015.
  22. Raiss P., Edwards T.B., da Silva M.R. Bruckner T., Loew M., Walch G. Reverse shoulder arthroplasty for the treatment of nonunions of the surgical neck of the proximal part of the humerus (type-3 fracture sequelae).J Bone Joint Surg Am. 2014;96(24):2070-2076. doi: 10.2106/JBJS.N.00405.
  23. Wey A., Dunn J.C., Kusnezov N., Waterman B.R., Kilcoyne K.G. Improved external rotation with concomitant reverse total shoulder arthroplasty and latissimus dorsi tendon transfer: A systematic review. J Orthop Surg (Hong Kong). 2017;25(2):2309499017718398. doi: 10.1177/2309499017718398.
  24. Popescu I.A., Bihel T., Henderson D., J.M. Becerra, Agneskirchner J., Lafosse L. Functional improvements in active elevation, external rotation, and internal rotation after reverse total shoulder arthroplasty with isolated latissimus dorsi transfer: surgical technique and midterm follow-up. J Shoulder Elbow Surg. 2019. 28(12):2356-2363. doi: 10.1016/j.jse.2019.04.039.

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