FUNCTIONAL OUTCOME AFTER REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF ACUTE COMPLEX PROXIMAL HUMERAL FRACTURES

The use of reverse shoulder arthroplasty (RSA) for proximal humeral fractures (PHFx) has expanded in recent decades. However, data on functional outcomes post-RSA for PHFx remain limited. This single-centre observational cohort study aimed to evaluate functional outcomes in patients undergoing RSA for PHFx using a single fracture specific design of RSA. Forty-six patients who underwent RSA using a Mathys Fracture Inverse prosthesis for acute complex three and four-part PHFx and fracture dislocations from 2014 to 2023 were prospectively reviewed. Procedures were performed by four fellowship trained shoulder surgeons. Patients were assessed independently at a minimum of one-year post-op. Outcome measures included time to functional recovery, range of motion (ROM) and patient reported outcome measures using the Oxford Shoulder Score (OSS). Five males and forty-one females were included, averaging 71.4 years of age (range: 59–85 years). The mean follow-up duration was 50.6 months (range: 16–118 months). All patients regained independent self-care, and all previous drivers returned to driving. Objective ROM showed mean values for flexion, abduction, and external rotation of 134□, 121□, and 29□, respectively. The mean OSS was 43.6/48. Patient satisfaction averaged 4.7/5, with 93% of patients reporting being satisfied or very satisfied. Three patients (6.5%) experienced complications comprising one case of radial nerve neuropraxia, and 2 (4.4%) re-operations; 1 washout for infection and 1 two-stage revision. In this study, RSA for acute PHFx or fracture-dislocation using a fracture specific prosthesis was associated with high rates of return to independence, high satisfaction scores and favorable patient reported outcome measures.