PDF herunterladen
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 529-539
DOI: 10.1055/s-0040-1721359
Artigo de Atualização
Ombro e Cotovelo

Artroplastia do ombro no tratamento das fraturas da extremidade proximal do úmero: Conceitos atuais[*]

Artikel in mehreren Sprachen: português | English
Geraldo da Rocha Motta Filho 
1   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
,
Marcus Vinícius Galvão Amaral
1   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Resumo

Fraturas complexas da extremidade proximal do úmero, especialmente em idosos, frequentemente necessitam de tratamento cirúrgico artroplástico. Tradicionalmente, a hemiartroplastia (HA) do ombro é o método de escolha, com longa sobrevida do implante, e oferece um ombro indolor, mas com resultados clínicos heterogêneos, relacionados ao correto posicionamento do implante quanto à altura e à versão, além da consolidação anatômica dos tubérculos. Atualmente, a utilização de artroplastias reversas do ombro para o tratamento dessas fraturas vêm aumentando exponencialmente, com melhores resultados funcionais do que as HAs, principalmente quanto à flexão anterior, apesar de a longevidade do implante ainda não ter sido estabelecida. O desenvolvimento de componentes umerais protéticos específicos para o tratamento de fraturas, introduzidos na prática clínica nos últimos anos, levou a resultados clínicos melhores.

Palavras-chave

artroplastia - ombro - fraturas ósseas

* Trabalho desenvolvido no Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.




Publikationsverlauf

Eingereicht: 24. August 2019

Angenommen: 16. September 2020

Artikel online veröffentlicht:
31. März 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res (Hoboken) 2012; 64 (03) 407-414
    CrossrefPubMedGoogle Scholar
  • 2 Neer II CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 1970; 52 (06) 1077-1089
    CrossrefPubMedGoogle Scholar
  • 3 Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture treatment in adults. J Bone Joint Surg Am 2014; 96 (03) 251-261
    CrossrefPubMedGoogle Scholar
  • 4 Checchia SL, Doneux PS, Miyazaki AN. et al. Tratamento das fraturas do terço proximal do úmero com a prótese parcial Eccentra®. Rev Bras Ortop 2005; 40 (03) 130-140
    Google Scholar
  • 5 Murachovsky J, Ikemoto RY, Nascimento LG, Fujiki EN, Milani C, Warner JJ. Pectoralis major tendon reference (PMT): a new method for accurate restoration of humeral length with hemiarthroplasty for fracture. J Shoulder Elbow Surg 2006; 15 (06) 675-678
    CrossrefPubMedGoogle Scholar
  • 6 Brandão BL, Amaral MV, Cohen M. et al. Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados. Rev Bras Ortop 2009; 44 (02) 106-111
    CrossrefPubMedGoogle Scholar
  • 7 Boileau P, Winter M, Cikes A. et al. Can surgeons predict what makes a good hemiarthroplasty for fracture?. J Shoulder Elbow Surg 2013; 22 (11) 1495-1506
    CrossrefPubMedGoogle Scholar
  • 8 Cadet ER, Ahmad CS. Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg 2012; 20 (01) 17-27
    CrossrefPubMedGoogle Scholar
  • 9 Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE. Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am 2003; 85 (07) 1215-1223
    CrossrefPubMedGoogle Scholar
  • 10 Mighell MA, Kolm GP, Collinge CA, Frankle MA. Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Shoulder Elbow Surg 2003; 12 (06) 569-577
    CrossrefPubMedGoogle Scholar
  • 11 Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br 2007; 89 (04) 516-520
    CrossrefPubMedGoogle Scholar
  • 12 Dillon MT, Prentice HA, Burfeind WE, Chan PH, Navarro RA. The increasing role of reverse total shoulder arthroplasty in the treatment of proximal humerus fractures. Injury 2019; 50 (03) 676-680
    CrossrefPubMedGoogle Scholar
  • 13 Jo YH, Lee KH, Lee BG. Surgical trends in elderly patients with proximal humeral fractures in South Korea: a population-based study. BMC Musculoskelet Disord 2019; 20 (01) 136
    CrossrefPubMedGoogle Scholar
  • 14 Neer II CS. Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 1970; 52 (06) 1090-1103
    CrossrefPubMedGoogle Scholar
  • 15 Boileau P, Sinnerton RJ, Chuinard C, Walch G. Arthroplasty of the shoulder. J Bone Joint Surg Br 2006; 88 (05) 562-575
    CrossrefPubMedGoogle Scholar
  • 16 Garofalo R, Flanagin B, Castagna A, Lo EY, Krishnan SG. Reverse shoulder arthroplasty for proximal humerus fracture using a dedicated stem: radiological outcomes at a minimum 2 years of follow-up-case series. J Orthop Surg Res 2015; 10: 129
    CrossrefPubMedGoogle Scholar
  • 17 Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 2005; 14 (1, Suppl S) 147S-161S
    CrossrefPubMedGoogle Scholar
  • 18 Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 2009; 17 (05) 284-295
    CrossrefPubMedGoogle Scholar
  • 19 Sebastiá-Forcada E, Cebrián-Gómez R, Lizaur-Utrilla A, Gil-Guillén V. Reverse shoulder arthroplasty versus hemiarthroplasty for acute proximal humeral fractures. A blinded, randomized, controlled, prospective study. J Shoulder Elbow Surg 2014; 23 (10) 1419-1426
    CrossrefPubMedGoogle Scholar
  • 20 Shukla DR, McAnany S, Kim J, Overley S, Parsons BO. Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elbow Surg 2016; 25 (02) 330-340
    CrossrefPubMedGoogle Scholar
  • 21 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 (03) 531-539
    CrossrefPubMedGoogle Scholar
  • 22 Bonnevialle N, Tournier C, Clavert P, Ohl X, Sirveaux F, Saragaglia D. la Société française de chirurgie orthopédique et traumatologique. Hemiarthroplasty versus reverse shoulder arthroplasty in 4-part displaced fractures of the proximal humerus: Multicenter retrospective study. Orthop Traumatol Surg Res 2016; 102 (05) 569-573
    CrossrefPubMedGoogle Scholar
  • 23 Gallinet D, Ohl X, Decroocq L, Dib C, Valenti P, Boileau P. French Society for Orthopaedic Surgery (SOFCOT). Is reverse total shoulder arthroplasty more effective than hemiarthroplasty for treating displaced proximal humerus fractures in older adults? A systematic review and meta-analysis. Orthop Traumatol Surg Res 2018; 104 (06) 759-766
    CrossrefPubMedGoogle Scholar
  • 24 Chen L, Xing F, Xiang Z. Effectiveness and safety of interventions for treating adults with displaced proximal humeral fracture: A network meta-analysis and systematic review. PLoS One 2016; 11 (11) e0166801
    CrossrefPubMedGoogle Scholar
  • 25 Du S, Ye J, Chen H, Li X, Lin Q. Interventions for Treating 3- or 4-part proximal humeral fractures in elderly patient: A network meta-analysis of randomized controlled trials. Int J Surg 2017; 48: 240-246
    CrossrefPubMedGoogle Scholar
  • 26 Cuff DJ, Pupello DR. Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients. J Bone Joint Surg Am 2013; 95 (22) 2050-2055
    CrossrefPubMedGoogle Scholar
  • 27 Mata-Fink A, Meinke M, Jones C, Kim B, Bell JE. Reverse shoulder arthroplasty for treatment of proximal humeral fractures in older adults: a systematic review. J Shoulder Elbow Surg 2013; 22 (12) 1737-1748
    CrossrefPubMedGoogle Scholar
  • 28 Baudi P, Campochiaro G, Serafini F. et al. Hemiarthroplasty versus reverse shoulder arthroplasty: comparative study of functional and radiological outcomes in the treatment of acute proximal humerus fracture. Musculoskelet Surg 2014; 98 (Suppl. 01) 19-25
    CrossrefPubMedGoogle Scholar
  • 29 Ferrel JR, Trinh TQ, Fischer RA. Reverse total shoulder arthroplasty versus hemiarthroplasty for proximal humeral fractures: a systematic review. J Orthop Trauma 2015; 29 (01) 60-68
    CrossrefPubMedGoogle Scholar
  • 30 Namdari S, Horneff JG, Baldwin K. Comparison of hemiarthroplasty and reverse arthroplasty for treatment of proximal humeral fractures: a systematic review. J Bone Joint Surg Am 2013; 95 (18) 1701-1708
    CrossrefPubMedGoogle Scholar
  • 31 Simovitch RW, Roche CP, Jones RB. et al. Effect of Tuberosity Healing on Clinical Outcomes in Elderly Patients Treated With a Reverse Shoulder Arthroplasty for 3- and 4-Part Proximal Humerus Fractures. J Orthop Trauma 2019; 33 (02) e39-e45
    CrossrefPubMedGoogle Scholar
  • 32 Chun YM, Kim DS, Lee DH, Shin SJ. Reverse shoulder arthroplasty for four-part proximal humerus fracture in elderly patients: can a healed tuberosity improve the functional outcomes?. J Shoulder Elbow Surg 2017; 26 (07) 1216-1221
    CrossrefPubMedGoogle Scholar
  • 33 Torrens C, Alentorn-Geli E, Mingo F, Gamba C, Santana F. Reverse shoulder arthroplasty for the treatment of acute complex proximal humeral fractures: Influence of greater tuberosity healing on the functional outcomes. J Orthop Surg (Hong Kong) 2018; 26 (01) 2309499018760132
    CrossrefPubMedGoogle Scholar
  • 34 Boileau P, Alta TD, Decroocq L. et al. Reverse shoulder arthroplasty for acute fractures in the elderly: is it worth reattaching the tuberosities?. J Shoulder Elbow Surg 2019; 28 (03) 437-444
    CrossrefPubMedGoogle Scholar
  • 35 Ohl X, Bonnevialle N, Gallinet D. et al. SOFCOT. How the greater tuberosity affects clinical outcomes after reverse shoulder arthroplasty for proximal humeral fractures. J Shoulder Elbow Surg 2018; 27 (12) 2139-2144
    CrossrefPubMedGoogle Scholar
  • 36 Torchia MT, Austin DC, Cozzolino N, Jacobowitz L, Bell JE. Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis. J Shoulder Elbow Surg 2019; 28 (04) 765-773
    CrossrefPubMedGoogle Scholar
  • 37 Seidl A, Sholder D, Warrender W. et al. Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?. Arch Bone Jt Surg 2017; 5 (04) 213-220
    PubMedGoogle Scholar
  • 38 Hamilton MA, Diep P, Roche C. et al. Effect of reverse shoulder design philosophy on muscle moment arms. J Orthop Res 2015; 33 (04) 605-613
    CrossrefPubMedGoogle Scholar
  • 39 Verdano MA, Aliani D, Galavotti C, Maroun C, Vaienti E, Ceccarelli F. Grammont versus lateralizing reverse shoulder arthroplasty for proximal humerus fracture: functional and radiographic outcomes. Musculoskelet Surg 2018; 102 (Suppl. 01) 57-65
    CrossrefPubMedGoogle Scholar
  • 40 Sirveaux F, Roche O, Molé D. Shoulder arthroplasty for acute proximal humerus fracture. Orthop Traumatol Surg Res 2010; 96 (06) 683-694
    CrossrefPubMedGoogle Scholar
  • 41 Barros LH, Figueiredo S, Marques M, Rodrigues C, Ramos J, Claro R. Tuberosity Healing after Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Is there Clinical Improvement? [Published online: 2020-02-07]. Rev Bras Ortop. Available from: https://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402459
    Google Scholar
  • 42 Schoch B, Aibinder W, Walters J. et al. Outcomes of Uncemented Versus Cemented Reverse Shoulder Arthroplasty for Proximal Humerus Fractures. Orthopedics 2019; 42 (02) e236-e241
    CrossrefPubMedGoogle Scholar
  • 43 Dezfuli B, King JJ, Farmer KW, Struk AM, Wright TW. Outcomes of reverse total shoulder arthroplasty as primary versus revision procedure for proximal humerus fractures. J Shoulder Elbow Surg 2016; 25 (07) 1133-1137
    CrossrefPubMedGoogle Scholar
  • 44 Gillespie R, Shishani Y, Joseph S, Streit JJ, Gobezie R. Neer Award 2015: A randomized, prospective evaluation on the effectiveness of tranexamic acid in reducing blood loss after total shoulder arthroplasty. J Shoulder Elbow Surg 2015; 24 (11) 1679-1684
    CrossrefPubMedGoogle Scholar
  • 45 Kirsch JM, Bedi A, Horner N. et al. Tranexamic Acid in Shoulder Arthroplasty: A Systematic Review and Meta-Analysis. JBJS Rev 2017; 5 (09) e3
    CrossrefPubMedGoogle Scholar
  • 46 Sun CX, Zhang L, Mi LD, Du GY, Sun XG, He SW. Efficiency and safety of tranexamic acid in reducing blood loss in total shoulder arthroplasty: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96 (22) e7015
    CrossrefPubMedGoogle Scholar
  • 47 Noguera L, Trigo L, Melero V, Santana F, Torrens C. Reverse shoulder arthroplasty for acute proximal humeral fractures: Postoperative complications at 7 days, 90 days and 1 year. Injury 2019; 50 (02) 371-375
    CrossrefPubMedGoogle Scholar
  • 48 Koh J, Galvin JW, Sing DC, Curry EJ, Li X. Thirty-day Complications and Readmission Rates in Elderly Patients After Shoulder Arthroplasty. J Am Acad Orthop Surg Glob Res Rev 2018; 2 (11) e068
    PubMedGoogle Scholar
  • 49 Lopiz Y, García-Coiradas J, Serrano-Mateo L, García-Fernández C, Marco F. Reverse shoulder arthroplasty for acute proximal humeral fractures in the geriatric patient: results, health-related quality of life and complication rates. Int Orthop 2016; 40 (04) 771-781
    CrossrefPubMedGoogle Scholar
  • 50 Austin DC, Torchia MT, Cozzolino NH, Jacobowitz LE, Bell JE. Decreased Reoperations and Improved Outcomes With Reverse Total Shoulder Arthroplasty in Comparison to Hemiarthroplasty for Geriatric Proximal Humerus Fractures: A Systematic Review and Meta-Analysis. J Orthop Trauma 2019; 33 (01) 49-57
    CrossrefPubMedGoogle Scholar
  • 51 Manoli A, Capriccioso CE, Konda SR, Egol KA. Total shoulder arthroplasty for proximal humerus fracture is associated with increased hospital charges despite a shorter length of stay. Orthop Traumatol Surg Res 2016; 102 (01) 19-24
    CrossrefPubMedGoogle Scholar
  • 52 Liu JN, Agarwalla A, Gowd AK. et al. Reverse shoulder arthroplasty for proximal humerus fracture: a more complex episode of care than for cuff tear arthropathy. J Shoulder Elbow Surg 2019; 28 (11) 2139-2146
    CrossrefPubMedGoogle Scholar
  • 53 Osterhoff G, O'Hara NN, D'Cruz J. et al. A Cost-Effectiveness analysis of reverse total shoulder arthroplasty versus hemiarthroplasty for the management of complex proximal humeral fractures in the elderly. Value Health 2017; 20 (03) 404-411
    CrossrefPubMedGoogle Scholar
  • 54 Solomon JA, Joseph SM, Shishani Y. et al. Cost Analysis of Hemiarthroplasty Versus Reverse Shoulder Arthroplasty for Fractures. Orthopedics 2016; 39 (04) 230-234
    CrossrefPubMedGoogle Scholar