Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae

The purpose of this study was to evaluate functional outcomes of reverse shoulder arthroplasty (RSA) in patients with acute fracture and sequelae of the proximal humeral fractures. Thirty-seven patients were treated with RSA for acute fracture and sequelae of a proximal humeral fracture. The average age was 73 years (range 50-87 years). Twenty-one patients had had no previous surgery, seven patients had acute fractures and 14 patients had chronic fractures. Sixteen patients had had previous surgery. Active range of motion and Constant score were evaluated at a minimum follow-up of two years. Active elevation was 102A degrees, external rotation 24A degrees, and internal rotation was up to L4 in all patients. In the group of patients without previous surgery treated with RSA, elevation was 116A degrees, external rotation 24A degrees, and internal rotation up to L3. In the group of patients with previous surgery treated with RSA, elevation was 84A degrees, external rotation 19A degrees, and internal rotation up to L4. In the group of patients with acute fracture treated with RSA, elevation was 124A degrees, external rotation 28A degrees, and internal rotation up to L4. In the group of patients with chronic or sequel of the fractures treated with RSA elevation was 114A degrees , external rotation 28A degrees, and internal rotation up to L3. Constant score in all patients was 54. Constant score in patients without previous surgery treated with RSA was 68 and with previous surgery it was 42. Patients without previous surgery treated with RSA for fractures had better functional results than patients who had undergone previous surgery.