![]() Scapular notching: This complication is specific to reverse shoulder replacement and occurs when the humeral component abuts against the scapula (shoulder blade). Regional pain syndrome: This can occur after fractures or surgery. Periprosthetic fracture: The shaft of the humerus may fracture during the course of the operation or if there is a further injury after the operation. Instability: The shoulder may dislocate after surgery but this is rare. In most instances it will resolve as you start moving the arm with the aid of physiotherapy. Stiffness: This is not uncommon following injury and surgery. In some instances the bone of the tuberosities may disappear over time. This will inevitably compromise the function of the shoulder. Tuberosity failure: If the bone is weak due to osteoporosis, the fixation of the tuberosities may fail leading to tuberosity migration. In very rare instances a blood vessel may be damaged as a consequence of injury or surgery. Several measures are employed to minimize the risk of infection including administration of antibiotics prior to the operation, an aseptic technique and the use of a clean air theatre.īleeding : Bleeding may occur during or after surgery. Infection: The risk of infection is 1-3%. It is designed to improve the mechanical efficiency of the deltoid muscle and provide a fulcrum for the joint.Ĭhest infection, Deep vein thrombosis, Pulmonary embolism, Myocardial infection are possible after surgery. The fixation is supplemented with bone graft using bone from the removed fragment.Ī Reverse shoulder replacement usually renders the shoulder relatively pain free and allows the use of the arm. The tuberosities (bone fragments which carry tendon attachments) are realigned and then fixed to the prosthesis and humeral shaft with sutures or cable. The shoulder is exposed, the humeral head (ball fragment) is removed, a metal hemisphere is fixed on to the socket (glenoid) of the shoulder and a metal prosthesis with a plastic cup insert is implanted in the shaft of the humerus. ![]() How is the procedure performed?Ī Reverse shoulder replacement is performed under a combination of general and regional anaesthesia. The alternatives for treating a proximal humerus fracture areĪ) Allow nature to take its course and have physiotherapy as pain easesī) operative fixation of the fracture, which may be suitable if the fragments of bone can be realigned and fixed with a plate and screws or an intramedullary nailĬ) a partial shoulder replacement (or Hemiarthroplasty), which may be appropriate if the tuberosity fragments are large and can be reconstructedĭ) a Reverse shoulder replacement, which is appropriate in older individuals in whom it is not possible to accurately reconstruct the fracture.
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