Outcomes of delayed reverse shoulder endoprosthesis in patients with fractures and fracture-dislocations of the proximal humerus

Aim. To investigate potential strategies for enhancing the treatment outcomes of patients with fractures and injuries to the proximal humerus through delayed reverse endoprosthesis.Materials and methods. From 2014 to 2022, reverse shoulder endoprosthesis (RSE) was performed on 64 patients aged 44 to 85 with fractures and dislocations. Among them, 39 patients were classified as elderly (60-74 years) at the time of surgery. Specifically, 22 patients underwent RSE within the first 6 months after the injury, 15 within the period from 6 to 12 months post-injury, and 27 were operated on no earlier than a year after the injury. Radiographs were analyzed, and postoperative complications and treatment results were evaluated before surgery, as well as at 3, 6, 12, and 24 months using the Constant Shoulder Score, UCLA, and ASES questionnaires.Results. Over a 2-year period post reverse shoulder endoprosthesis (RSE), there was a notable improvement in average scores across all assessment scales: Constant Shoulder Score improved from 18.2 ± 10.5 to 69.9 ± 20.7 points; ASES increased from 22.0 ± 10.3 to 82.0 ± 14.4 points, and UCLA rose from 14.7 ± 21.3 to 27.8 ± 5.92 points.Conclusions. Performing reverse shoulder endoprosthesis in patients with fractures and fractures-dislocations of the humerus in the delayed period allows achieving better treatment outcomes. Reverse shoulder endoprosthesis is a complex operation and is associated with a fairly large number of complications. Hence, engaging surgeons with expertise in such procedures is recommended.