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Vol. 5  Issue 4, 2023

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Georgian Scientists/ . 5  N 4, 2023 296

Reverse shoulder arthroplasty for treatment of proximal humeral fractures: Case report

Subeliani D., Cikvatia L.,

Tbilisi State Medical Universiry

Abstract

A proximal end fracture of the humeral bone is one of the often common fractures and ranks third in
terms of frequency (after a fracture of the hip and forearm). Due to the fact that the shoulder joint is
one of the complex joints in the human body, the incorrectly selected method of treating an
intraarticular multi-fragmented fracture of the shoulder joint leads to unsatisfactory consequences in
the postoperative period and a high degree of disability. As with other types of surgical interventions,
osteosynthesis and arthroplasty of a multifractional fracture at the proximal end of the humeral bone
are associated with a high degree of disability. The most common problem of them is the unsatisfactory
function of  the  limb in  the  postoperative  period,  which leads  to  a  deplorable  consequence  –  a  solid
decrease  in  disability.  Today  there  is  no  uniform  rule  that  allows  both  the  pros  and  cons  of  any
treatment method to be determined during the operational period. The most effective methods in terms
of results among the operational methods available today are osteosynthesis with a metal plate and
screw,  although  today  the  trend  in  developed  countries  around  the  world  is  the  tendency  to
arthroplasty of the upper end of the shoulder joint in the acute period of multifractional fracture, which
ensures the activation of the disease in the early stages of surgery and the relieve of pain syndrome.

This particular case study describes the clinical case presentation, diagnosis, management, and outcome
of a 72-year-old patient, who had a multifragmentary fracture of the proximal end of the humerus that
underwent osteosynthesis with a locking plate and screws, However, in a few months, avascular
necrosis  of  the  proximal  end  of  the  shoulder  was  formed  and  it  became  necessary  to  undergo
endoprosthesis of the shoulder joint with a reverse endoprosthesis.