{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:32:52Z","timestamp":1786984372031,"version":"build-2736575974"},"reference-count":28,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"4","license":[{"start":{"date-parts":[[2020,2,6]],"date-time":"2020-02-06T00:00:00Z","timestamp":1580947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjective\nThe aim of this study was to analyze and compare the results of reverse shoulder arthroplasty (RSA) in proximal humeral fracture sequelae (PHFS) in fractures initially treated conservatively versus those initially treated with open reduction and internal fixation (ORIF).\nMethods\nIt is a retrospective study that includes all PHFS treated with a RSA from September 2006 to December 2013. Twenty-seven patients met the inclusion criteria. There were 9 patients (7 females and 2 males; mean age: 79.11 years) treated with RSA due to a fracture sequelae following conservative treatment and 18 patients (15 females and 3 males; mean age: 76.83 years) treated with a RSA owing to a fracture sequelae after ORIF. The functional outcome was recorded with the aid of the pre-surgery Constant Score and at the latest follow-up (minimum of two years). All the patients included underwent an imaging study that included plain X-Rays and a CT scan prior to surgery and plain X-Rays after surgery. All complications and reoperations during follow-up were also recorded.\nResults\nBoth groups had significantly increased Constant Scores after surgery (p &lt; 0.0001), but the patients in the conservative group had significantly better outcomes for the total Constant Score (p = 0.024), for forward elevation (p = 0.026) and for external rotation (p = 0.004). A total of 4 complications (14.8%) were present during the follow-up period. In the conservative group, 1 patient developed an infection and there were 2 dislocations and 1 infection in the ORIF group.\nConclusion\nThe use of RSA in the treatment of PHFS results in a limited outcome improvement but with an acceptable complication rate. Patients developing PHFS after conservative treatment may expect better outcomes and fewer complications than those developing PHFS after ORIF.\n\n\nLevel of evidence\nLevel IV, Therapeutic Study.\nER -<\/jats:p>","DOI":"10.1016\/j.aott.2019.03.010","type":"journal-article","created":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T11:51:27Z","timestamp":1554983487000},"page":"278-281","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":13,"title":["Reverse shoulder arthroplasty for fracture sequelae: How the initial fracture treatment influences the outcomes of joint replacement"],"prefix":"10.5152","volume":"53","author":[{"given":"Fernando","family":"SANTANA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"ALENTORN-GEL\u0130","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"GU\u0130RRO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"TORRENS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,6]]},"reference":[{"key":"10.1016\/j.aott.2019.03.010_bib1","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1302\/0301-620X.86B6.14577","article-title":"Internal fixation of complex fractures of the proximal humerus","volume":"86","author":"Gerber","year":"2004","journal-title":"J\u00a0Bone Joint Surg Br Vol"},{"key":"10.1016\/j.aott.2019.03.010_bib2","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.jse.2012.06.008","article-title":"Locking plate fixation of fractures of the proximal humerus: analysis of complications, revision strategies and outcome","volume":"22","author":"Jost","year":"2013","journal-title":"J\u00a0Shoulder Elbow Surg"},{"key":"10.1016\/j.aott.2019.03.010_bib3","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2106\/JBJS.F.01351","article-title":"Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fractures [corrected]","volume":"90","author":"Owsley","year":"2008","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.aott.2019.03.010_bib4","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.2106\/JBJS.H.00006","article-title":"Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. 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Publishing services by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}