Akademik Veri Yönetim Sistemi
Istanbul Tip Fakultesi Dergisi, cilt.88, sa.3, ss.178-184, 2025 (ESCI)
Objective: Proximal humeral fractures (PHFs) are common among the elderly with numerous treatment options. Especially for complex fractures, reverse shoulder arthroplasty (RSA) has become a popular treatment alternative. However, effects of different RSA designs in the setting of PHFs have not been clarified yet. The purpose of this study was to compare the clinical and radiological outcomes of inlay (medialized) and onlay (lateralized) design RSAs performed for PHFs. Material and Methods: A retrospective evaluation was conducted on patients who underwent RSA for PHF between December 2016 and September 2023. The patients were divided into two study groups based on the prosthetic design: Group I (inlay) and Group II (onlay). Clinical and radiological outcome data of the final followup visits were compared between the study groups. The clinical outcome measures included the pain score (visual analogue scale – VAS), simple shoulder test (SST), and subjective shoulder value (SSV). Tuberosity healing was evaluated using follow-up radiographs. Results: A total of 74 patients were included in the study. There were 26 patients in group I and 48 patients in group II. The mean age of the patients was 72.4±7.2 years, and the mean follow-up duration was 51.2±25.4 months. The tuberosity healing rate was higher in group I; however, the difference showed no significance (61.5% vs 54.2%, p>0.05). The two study groups were comparable in terms of clinical outcomes (p>0.05). Conclusion: The findings of this study showed that, despite the absence of tuberosity healing in nearly half of the patients, both prosthetic designs resulted in satisfactory clinical outcomes. Although the inlay design group had a higher rate of tuberosity healing, the difference was not statistically significant, and further research is needed to confirm any potential superiority.