Treatment of complex acute proximal humerus fractures using hemiarthroplasty Tratamento das fraturas complexas agudas da extremidade proximal do úmero com o uso de hemiartroplastia

OBJECTIVE: Evaluate the clinical and radiological results of hemiarthroplasty for treatment of complex proximal humerus fractures. METHODS: Sixty-seven patients were included, with follow-up of 12 to 62 months. Mean age was 65 years (44 to 88), and 47 patients were female (70%). Clinical assessment was performed using the University of California Los Angeles score (UCLA) and measurement of range of motion (ROM) according to the American Academy of Orthopaedic Surgeons criteria. A standardized radiological evaluation was conducted, with special attention to healing and position of tuberosities. Patients were divided into two groups: A (anatomical healing of tuberosities) and B (without anatomical healing of tuberosities). Statistical analyses were performed using the t test. Level of significance was set at p < 0.05. RESULTS: Considering the entire sample, the mean UCLA score was 26 points, with 8 points for pain and 64 patients subjectively satisfied (96%). The mean values for active ROM were 104o of forward flexion and 36o of external rotation. In group A, with 33 patients, we found a mean of 122o forward flexion and 29.5 points on UCLA. In group B the mean forward flexion were 87o and 22.7 points for UCLA. Comparing these parameters in the two groups, we found statistically significant differences for both forward flexion (p < 0.0001) and UCLA. (p < 0.0001). CONCLUSION: We conclude that hemiarthroplasty for treatment of complex proximal humerus fractures has a low incidence of complications and a high subjective satisfaction rate, with favorable results related to pain. A good functional result is less predictable and depends on anatomical reestablishment of proximal humerus anatomy, particularly healing of the greater tuberosity. OBJETIVO: Avaliar os resultados funcionais e radiográficos dos pacientes submetidos à hemiartroplastia para tratamento das fraturas complexas da extremidade proximal do úmero. MéTODOS: Foram incluídos 67 pacientes, com seguimento que variou entre 12 e 62 meses. A média de idade foi de 65 anos (44 a 88) e 47 pacientes eram do sexo feminino (70%). Os pacientes foram avaliados clinicamente por meio da avalia o da amplitude de movimentos (ADM) e do escore funcional da University of California Los Angeles (UCLA). A avalia o radiográfica foi feita de forma padronizada com divis o dos pacientes em dois grupos: A (consolida o do tubérculo maior em posi o anat mica) e B (ausência de consolida o anat mica do tubérculo maior). Na análise estatística consideramos significativos os achados com p < 0,05. RESULTADOS: A pontua o média