Skip to main content

Treatment of Post-traumatic Sequelae with Shoulder Arthroplasty

  • Chapter
  • First Online:
Complex and Revision Shoulder Arthroplasty
  • 560 Accesses

Abstract

The incidence of proximal humerus fractures is increasing; most are treated non-operatively, but sequelae of these fractures remain a treatment challenge whether surgery has been performed or not. A common classification system can assist treating physicians with diagnosis and treatment options based upon expected outcomes. Reverse shoulder arthroplasty is the likely “go-to” procedure for the majority of these patients, but anatomic arthroplasty and other reconstructive options should be considered for specific sequelae patterns.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chuinard C, Boileau P, Walch G. Evaluation and prosthetic management of proximal humeral malunions. In: Iannotti JP, Williams GR, editors. Disorders of the shoulder: reconstruction. Philadelphia: Lippincott Williams and Wilkins; 2014.

    Google Scholar 

  2. Jost B, Spross C, Grehn H, Gerber C. Locking plate fixation of fractures of the proximal humerus: analysis of complications, revision strategies and outcome. J Shoulder Elb Surg. 2013;22:542–9.

    Article  Google Scholar 

  3. Cadet ER, Yin B, Schulz B, Ahmad CS, Rosenwasser MP. Proximal humerus and humeral shaft nonunions. J Am Acad Orthop Surg. 2013;21:538–47.

    PubMed  Google Scholar 

  4. Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res. 2012;64:407–14.

    Article  Google Scholar 

  5. Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN. Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg Am. 2011;93(2):121–31.

    Article  Google Scholar 

  6. Antuna SA, Sperling JW, Sanchez-Sotelo J, Cofield RH. Shoulder arthroplasty for proximal humeral nonunions. J Shoulder Elb Surg. 2002;11:114–21.

    Article  Google Scholar 

  7. Antuna SA, Sperling JW, Sanchez-Sotelo J, Cofield RH. Shoulder arthroplasty for proximal humeral malunions: Long-term results. J Shoulder Elb Surg. 2002;11:122–9.

    Article  Google Scholar 

  8. Antuna SA, Sperling JW. Prosthetic replacement for nonunions of proximal humeral fractures. In: Cofield R, Sperling J, editors. Revision and complex shoulder arthroplasty. Philadelphia: Lippincott, Williams and Wilkins; 2010. p. 259–65.

    Google Scholar 

  9. Beredjiklian PK, Iannotti JP, Norris TR, Williams GR. Operative treatment of malunion a fracture of the proximal aspect of the humerus. J Bone Joint Surg. 1998;80A:1484–97.

    Article  Google Scholar 

  10. Boileau P, Walch G. The three-dimensional geometry of the proximal humerus: implications for surgical technique and prosthetic design. J Bone Joint Surg. 1997;79B:857–65.

    Google Scholar 

  11. Boileau P, Walch G, Trojani C, Sinnerton R, Romeo AA, Veneau B. Sequelae of fractures of the proximal humerus : surgical classification and limits of shoulder arthroplasty. In: Walch G, Boileau P, editors. Shoulder arthroplasty. Berlin: Springer-Verlag; 1999. p. 349–58.

    Chapter  Google Scholar 

  12. Boileau P, Trojani C, Walch G, Krishnan S, Romeo A, Sinnerton R. Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elb Surg. 2001;10:299–308.

    Article  CAS  Google Scholar 

  13. Boileau P, Chuinard C, LeHuec JC, Walch G, Trojani C. Proximal humerus fracture sequelae: Impact of a new radiographic classification on arthroplasty. Clin Ortho Rel Res. 2006;442:121–30.

    Article  Google Scholar 

  14. Chuinard C. Fracture sequelae revisited. In: Boileau P, editor. Shoulder concepts. Montpillier: Sauramps Medical; 2008. p. 179–91.

    Google Scholar 

  15. Constant CR, Murley AHG. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–4.

    Google Scholar 

  16. Flatow EL, Neer CS II. Chronic anterior dislocation of the shoulder. J Shoulder Elb Surg. 1993;2(1):2–10.

    Article  CAS  Google Scholar 

  17. Hawkins RJ, Neer CS II. Locked posterior dislocation of the shoulder. J Bone Joint Surg. 1987;69A:9–18.

    Article  Google Scholar 

  18. Healy WL, Jupiter JB, Kristiansen TK, White RR. Nonunion of the proximal humerus. In: Post M, Morrey BF, Hawkins RJ, editors. Surgery of the shoulder. St. Louis: Mosby-Year Book; 1990. p. 59.

    Google Scholar 

  19. Huten D, Duparc J. L’arthroplastie prothétique dans les traumatismes complexes récents et anciens de l'épaule. Rev Chir Orthop. 1986;72:517–29.

    CAS  PubMed  Google Scholar 

  20. Iannotti JP, Sidor ML. Malunions of the proximal humerus. In: Warner JP, Iannotti JP, Gerber C, editors. Complex and revision problems in shoulder surgery. Philadelphia: Lippincott-Raven Publishers; 1997. p. 245–64.

    Google Scholar 

  21. Keene JS, Huizenga RE, Engber WD, Rogers SC. Proximal humeral fractures: a correlation of residual deformity with long term function. Orthopedics. 1983;6:173.

    CAS  PubMed  Google Scholar 

  22. Kyle RF, Conner TN. Post-traumatic avascular necrosis of the humeral head in displaced proximal humeral fractures. J Trauma. 1981;21:788–91.

    Article  Google Scholar 

  23. Lollino N, Paladini P, Campi F, Merolla G, Rossi P, Porcellini G. Reverse shoulder prosthesis as revision surgery after fractures of the proximal humerus, treated initially by internal fixation or hemiarthroplasty. Musculoskelet Surg. 2009;93:S35–9.

    Article  Google Scholar 

  24. Neer CS II. Nonunion of the surgical neck of the humerus. Orthop Trans. 1983;3:389.

    Google Scholar 

  25. Norris TR, Turner JA, Bovill D. Nonunion of the upper humerus: an analysis of the etiology and treatment in 28 cases. In: Post M, Morrey BF, Hawkins RJ, editors. Surgery of the shoulder. St. Louis: Mosby-Year Book; 1990. p. 63.

    Google Scholar 

  26. Pritchett JW. Prosthetic replacement for chronic unreduced dislocations of the shoulder. Clin Orthop Relat Res. 1987;216:89–93.

    Google Scholar 

  27. Dines DM, Klarren RF, Altcheck DW, Moeckel B. Posttraumatic changes of the proximal humerus: Malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty. J Shoulder Elb Surg. 1993;2(1):11–21.

    Article  CAS  Google Scholar 

  28. Mansat P, Guity M, Bellumore Y, Mansat M. Shoulder arthroplasty for late sequelae of proximal humeral fractures. J Shoulder Elb Surg. 2004;13:305–12.

    Article  Google Scholar 

  29. Martin T, Iannotti J. Reverse total shoulder arthroplasty for acute fractures and failed management after proximal humeral fractures. Orthop Clin N Am. 2008;39:451–7.

    Article  Google Scholar 

  30. Moineau G, Boileau P. Post-traumatic cephalic collapse and necrosis (Type-1 fracture sequelae): results of a nonconstrained anatomical prosthesis. In: Boileau P, editor. Shoulder concepts 2008. Montpillier: Sauramps Medical; 2008. p. 193–208.

    Google Scholar 

  31. Neer CS II. Old trauma in glenohumeral arthroplasty. In:Shoulder reconstruction. 3rd ed. Philadelphia: Saunders; 1990. p. 222–34.

    Google Scholar 

  32. Norris TR, Turner JA. Late prosthetic shoulder arthroplasty for displaced proximal humerus fractures. J Shoulder Elb Surg. 1995;4:271–80.

    Article  CAS  Google Scholar 

  33. Rowe CR, Zarins B. Chronic unreduced dislocations of the shoulder. J Bone Joint Surg. 1982;64A:494–505.

    Article  Google Scholar 

  34. Tauber M, Karpik S, Matis N, Schwartz M, Resch H. Shoulder arthroplasty for traumatic avascular necrosis. Predictors of outcome. Clin Orthop Relat Res. 2007;465:208–14.

    PubMed  Google Scholar 

  35. Tauber M, Resch H. Prosthetic arthroplasty for delayed complications of proximal humerus fractures. In: Cofield R, Sperling J, editors. Revision and complex shoulder arthroplasty. Philadelphia: Lippincott, Williams and Wilkins; 2010. p. 250–8.

    Google Scholar 

  36. Walch G, Badet R, Nove-Josserand L, Levigne C. Nonunions of the surgical neck of the humerus: surgical treatment with an intramedullary bone peg, internal fixation and cancellous bone grafting. J Shoulder Elb Surg. 1996;5:161–8.

    Article  CAS  Google Scholar 

  37. Cofield RH. Shoulder replacement: prognosis related to diagnosis. In: Kôlbel R, Helbig B, Blauth W, editors. Shoulder replacement. Berlin: Springer; 1987. p. 157–61.

    Chapter  Google Scholar 

  38. Cofield R. Nonconstrained arthroplasty of the shoulder for severe malunions. In: Boileau P, editor. Shoulder concepts. Montpillier: Sauramps Medical; 2008. p. 259–63.

    Google Scholar 

  39. Cheung E, Sperling J. Management of proximal humeral nonunions and malunions. Orthop Clin N Am. 2008;39:475–82.

    Article  Google Scholar 

  40. Duralde XA, Flatow EL, Pollock RG, Nicholson GP, Self EB, Bigliani LU. Operative treatment of nonunions of the surgical neck of the humerus. J Shoulder Elb Surg. 1996;5(3):169–80.

    Article  CAS  Google Scholar 

  41. Frich LH, Sjoberg JO, Sneppen O. Shoulder arthroplasty in complex acute and chronic proximal humerus fractures. Orthopaedics. 1991;14:949–54.

    CAS  Google Scholar 

  42. Ritzman T, Iannotti J. Malunions, nonunions, and other complications of proximal humerus fractures. In: Iannotti J, Williams G, editors. Disorders of the shoulder, diagnosis and management. Philadelphia: Lippincott, Williams and Wilkins; 2007. p. 907–42.

    Google Scholar 

  43. Razemon JP, Baux S. Les séquelles des fractures de l’extrémité supérieure de l’humérus. Rev Chir Orthop. 1969;55:479–90.

    Google Scholar 

  44. Waiter JM, Flatow E. Posttraumatic arthritis. Ortho Clin North Am. 2000;31:63–76.

    Article  Google Scholar 

  45. Walch G, Boileau P, Martin B, Dejour H. Unreduced posterior dislocations and fracture-dislocations of the shoulder. A review of 30 cases. J Orthop Surg. 1990;4:93–5.

    Google Scholar 

  46. Scheck M. Surgical treatment of nonunions of the surgical neck of the humerus. Clin Orthop Relat Res. 1982;167:255–9.

    Google Scholar 

  47. Stechel A, Fuhrmann U, Irlenbusch L, Rott O, Irlenbusch U. Reversed shoulder arthroplasty in cuff tear arthritis, fracture sequelae, and revision arthroplasty. Outcome in 59 patients followed for 2–7 years. Acta Orthop. 2010;81:367–72.

    Article  Google Scholar 

  48. Levy J, Frankle M, Mighell M, Pupello D. The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg. 2007;89A:292–300.

    Article  Google Scholar 

  49. Neyton L, Garaud P, Boileau P. Results of reverse shoulder arthroplasty in proximal humerus fracture sequelae. In:Reverse shoulder arthroplasty. Montpellier: Sauramps Medical; 2006. p. 81–101.

    Google Scholar 

  50. Watson KC. Indications and considerations of shoulder replacement in post-traumatic conditions. In: Köbel R, Helbig B, Blauth W, editors. Shoulder replacement. Berlin: Springer; 1987. p. 129–33.

    Chapter  Google Scholar 

  51. Lee CK, Hansen HR. Post-traumatic avascular necrosis of the humeral head in displaced proximal humeral fractures. J Trauma. 1981;21:788–91.

    Article  CAS  Google Scholar 

  52. Raiss P, Alami G, Bruckner T, Magosch P, Habermeyer P, Boileau P, Walch G. Reverse shoulder arthroplasty for type 1 sequelae of a fracture of the proximal humerus. Bone Joint J. 2018;100-B:318–23.

    Article  CAS  Google Scholar 

  53. Quadlbauer S, Hofmann GJ, Leixnering M, Rosenauer R4, Hausner T4, Reichetseder J. Open reduction and fixation with a locking plate without bone grafting is a reasonable and safe option for treating proximal humerus nonunion. Int Orthop. 2018;42:2199.

    Article  Google Scholar 

  54. Raiss P, Edwards TB, da Silva MR, 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;96:2070–6.

    Article  Google Scholar 

  55. Raiss P, Edwards TB, Collin P, Bruckner T, Zeifang F, Loew M, Boileau P, Walch G. Reverse shoulder arthroplasty for malunions of the proximal part of the humerus (Type-4 fracture sequelae). J Bone Joint Surg Am. 2016;98:893–9.

    Article  Google Scholar 

  56. Schliemann B, Theisen C, Kösters C, Raschke MJ, Weimann A. Reverse total shoulder arthroplasty for type I fracture sequelae after internal fixation of proximal humerus fractures. Arch Orthop Trauma Surg. 2017;137:1677–83.

    Article  Google Scholar 

  57. Grubhofer F, Wieser K, Meyer DC, Catanzaro S, Schürholz K, Gerber C. Reverse total shoulder arthroplasty for failed open reduction and internal fixation of fractures of the proximal humerus. J Shoulder Elb Surg. 2017;26:92–100.

    Article  Google Scholar 

  58. Sanchez-Sotelo J, Wagner ER, Sim FH, Houdek MT. Allograft-prosthetic composite reconstruction for massive proximal humeral bone loss in reverse shoulder arthroplasty. J Bone Joint Surg Am. 2017;99:2069–76.

    Article  Google Scholar 

  59. Wagner ER, McLaughlin R, Sarfani S, Cofield RH, Sperling JW, Sanchez-Sotelo J, Elhassan BT. Long-term outcomes of glenohumeral arthrodesis. J Bone Joint Surg Am. 2018;100:598–604.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chuinard, C. (2019). Treatment of Post-traumatic Sequelae with Shoulder Arthroplasty. In: Tashjian, R. (eds) Complex and Revision Shoulder Arthroplasty . Springer, Cham. https://doi.org/10.1007/978-3-030-02756-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-02756-8_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02755-1

  • Online ISBN: 978-3-030-02756-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics