Reverse or hemi shoulder arthroplasty in proximal humerus fractures: A single blinded prospective multi-center randomized clinical trial

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

Thirty-one patients who sustained isolated 3 or 4 part dislocated proximal humerus fractures presenting to the emergency department were randomized to undergo a hemiarthroplasty (HA; n=14) or reversed shoulder arthroplasty (RSA; n=17). The primary outcome of interest was range of motion (ROM) as well as function evaluated by the Constant-Murley Shoulder (CMS) Outcome Score, were both measured at 6 weeks and 3, 6, and 12 months follow-up. Secondary outcomes of measured included pain using the visual analogue scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH), and Short Form 12 Health Survey (SF-12) (i.e. mental and physical components). VAS was measured at 6 weeks and 3, 6, and 12 months follow-up. DASH and SF-12 were evaluated at 3 and 12 months follow-up. Results revealed that CMS was statistically significantly improved at 6 and 12 months follow-up in the RSA group (p=0.01; p=0.05, respectively). ROM internal rotation was statistically significantly favored in the HA group at 6 weeks only (p<0.001) but this change was not observed afterwards at any of the other follow-ups (p>0.05). ROM anterior elevation was statistically significantly favored in the RSA group at 6 and 12 months follow-up (p=0.0020 and p=0.02, respectively) whereas ROM abduction was only found statistically significantly different at 12 months follow-up (p=0.01). Finally, VAS was statistically significantly lower in the RSA group at 12 months follow-up only (p=0.05). SF-12 and DASH scores were not statistically significantly different between the 2 groups at 3 and 12 months follow-up (p>0.05). Radiological healing of the tuberosities and heterotopic ossification were also not statistically significantly different across groups (p>0.05); 2 patients had nonunion and 1 patient had malunion in the RSA group, whilst no cases were observed in the HA group.