EC Orthopaedics

Background: Tuberosity healing in proximal humerus fractures (PHFs) has been associated with better outcomes for hemiarthroplasty, however, there is still debate concerning its effects in reverse shoulder arthroplasty (RSA). This study aims to assess the current state of the knowledge regarding the impact of tuberosity healing in PHFs treated with RSA, evaluate the functional results of patients with complex PHFs submitted to RSA with and without tuberosity healing and to evaluate the tuberosity healing rate after RSA.

Methods: A scoping review was conducted with a multi-database search and data from the published literature meeting inclusion criteria were reviewed and evaluated.

Results: Fifteen studies (including 1085 patients) were included. Weighted mean age was 75,1 years old, and weighted female percentage was 79,9%. The weighted healing rate was 59,3%. Patients in the tuberosity healed group demonstrated a statistically significant superior Constant-Murley Score (CMS) in 6 of the total 15 studies included.

Conclusion: Tuberosity healing appears to provide better CMS and accordingly, superior overall shoulder function, following RSA for PHFs. The tuberosity healing also seems to impact RSA biomechanics primarily during external rotation. Further randomized controlled trials are needed to confirm the benefits of tuberosity healing.

 Keywords: Shoulder Arthroplasty; Reverse Total Shoulder Arthroplasty; Tuberosity fixation; Tuberosity Healing

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