Reconstruction of humeral length and centering of the prosthetic head in hemiarthroplasty for proximal humeral fractures |
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| Authors: | Greiner Stefan H Kääb Max J Kröning Iris Scheibel Markus Perka Carsten |
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| Affiliation: | 1. London Health Sciences Centre, University Hospital, 339 Windermere Rd., London, ON N6A 5A5, Canada;2. Hand and Upper Limb Centre, St. Joseph''s Health Care, London, ON N6A 4V2, Canada;1. Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan;2. Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan;3. Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan;4. Clinical Biomechanics Laboratory, Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan |
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| Abstract: | Anatomic reconstruction of humeral length in hemiarthroplasty for complex proximal humeral fractures is difficult because reliable surgical landmarks are missing or are destroyed by the fracture. The pectoralis major tendon is a reliable landmark to determine prosthetic height intraoperatively. This study analyzed the clinical outcome, reconstruction of humeral length, centering of the prosthetic head in the glenoid, and tuberosity positioning and healing, using the pectoralis major tendon as a reference intraoperatively. The study included 30 patients. In 21 patients (group 1), humeral length reconstruction was performed using the pectoralis major tendon as a reference; in 9 (group 2), this reference was not used. Patients underwent a clinical and radiologic evaluation at a mean of 22.7 months. Group 1 showed significantly better results in clinical and radiologic values, especially in anatomic reconstruction of humeral length, than group 2. Clinical outcome depended significantly on greater tuberosity healing and centering of the prosthetic head in the glenoid. |
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