Hemiarthroplasty for Proximal Humerus Fractures in Patients with Parkinson’s Disease

Thomas J. Kryzak MD, John W. Sperling MD, MBA, Cathy D. Schleck BSc, Robert H. Cofield MD
Clinical Research
Volume 468, Issue 7 / July , 2010

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Abstract

Background

Parkinson’s disease is a relatively common problem in geriatric patients with an annual incidence rate of 20.5 per 100,000. These patients are at increased risk for falls and resultant fractures. Several reports suggest total shoulder arthroplasty in patients with fractures has a relatively high rate of complications. Whether hemiarthroplasty reduces the rate of complications or improves pain or function is not known.

Questions/purposes

We therefore determined the ROM, pain, complications, and rate of failure of hemiarthroplasty for management of proximal humerus fractures in patients with Parkinson’s disease.

Patients and Methods

We retrospectively reviewed all eight hemiarthroplasties in patients with Parkinson’s disease for fracture of the proximal humerus between 1978 and 2005. Seven patients (seven shoulders) had a minimum of 2 years followup (mean, 9.9 years; range, 2–16 years).

Results

Postoperatively, the mean active abduction was 97°, mean external rotation was 38°, and internal rotation was a mean of being able to reach the level of the sacrum. The mean postoperative pain score was 2.5 points (on a scale of 1–5). There was a greater tuberosity nonunion in one patient and a superior malunion of the greater tuberosity in three patients. No patient had revision surgery.

Conclusions

The benefit of hemiarthroplasty for proximal humerus fractures in patients with Parkinson’s disease was marginal with three shoulders in seven patients having moderate to severe persistent pain and limited function postoperatively.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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