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When a shoulder fracture occurs, or heals poorly, it may be time to consider surgical options. Today there are alternatives that provide pain relief and freedom of movement. Over 60,000 Americans have shoulder replacement procedures each year, many experiencing reduced pain and improved function.1 In fact, shoulder replacement is the third most common joint replacement.2
When the main arm bone (humerus) is broken in 3 or more places, a doctor may suggest shoulder replacement surgery to restore movement and reduce pain.
Humerus fractures are most often caused by a direct blow or by a fall. In the U.S., humerus fractures represent 4% to 5% of all fractures.3 Older persons are more likely to break bones because of osteoporosis (thinning of the bones).
Fractures are either "displaced," meaning the fractured bone fragments have moved out of their natural alignment, or "non-displaced" if the broken pieces remain close to where they were before the injury. In non-displaced fractures, usually a sling is used to keep the shoulder from moving while the bone heals.
About 20% of shoulder fractures are displaced and may require the doctor to move the bones back into proper position. If the ball portion at the top of the arm bone is broken, split, or crushed, a shoulder replacement may be needed.
DePuy shoulders are designed to closely reproduce the smooth, complex movement of the natural shoulder. That’s why each DePuy shoulder implant is based on detailed studies of the shoulder, its structure, and function. DePuy shoulders are also designed to spare as much healthy bone and tissue as possible to help you keep moving. And a wide array of styles and sizes allows your surgeon to select the implant that fits you best.
DePuy shoulders incorporate technologically advanced materials designed to resist the type of wear that typically occurs in shoulder joints. For example, Premieron™ cross-linked polyethylene, used to replace the shoulder socket and replicate a smooth cartilage surface, reduces wear by 85% over traditional polyethylene.4 The less wear, the longer a new shoulder can be expected to last. However, all shoulder implants may need replacement at some point.
What are the benefits of the DePuy Global Fx Shoulder Fracture System?
A recent review of various studies by Drs. John Naranja and Joseph Iannotti found that shoulder replacement surgery reduced pain in the shoulder joint in most people.3,5 They also noted an improved range of motion in those who underwent this operation. Modular implants, like those found in the Global Fx System, had a favorable impact on the results of shoulder replacement surgery.
Shoulder replacement surgery is recommended if you have:
Shoulder replacement surgery for a fracture may be suggested for patients who would potentially have difficulty recovering from a shoulder fracture. Older patients may have more problems with slower and less permanent bone healing after fracture, so the surgeon may choose to replace the shoulder to help relieve the pain.
Only an orthopaedic surgeon trained in shoulder replacement can provide advice about whether shoulder replacement surgery is right for you. See your physician to learn more. The performance of a joint replacement depends on age, weight, activity level and other factors. There are potential risks and recovery takes time. People with current infections or conditions limiting rehabilitation should not have this surgery. The most common adverse events after shoulder replacement are loosening, infection, and fracture of the implant or bone. You and your surgeon must weigh the benefits of surgery against potential risks.
The following are the most frequent adverse events after shoulder arthroplasty: change in position of the components, loosening of components, dislocation, infection, hematoma, pneumonia, and cardiovascular disorders.
1 US Markets for Small Joint Devices. Toronto: Millenium Research Group; 2007.
2 Joshi D. Total shoulder replacement—the 3rd most replaced joint in America! Available at: http://www.pearldiverinc.com/pdp/index.php Accessed on Jan. 27, 2009.
3 Iannotti JP, Sider ML. Malunions of the proximal humerus: complex and revision problems in shoulder surgery. 1997;vol: 245-264.
4 Klotz C, Deffenbaugh DL, McNulty D, et al. Cross-Linked Glenoid Prosthesis: A Wear Comparison to Current Glenoid Prostheses. Warsaw, IN: DePuy Orthopaedics, Inc.; 2006. Cat. No. 0612-00-585.
5 Naranja RJ, Iannotti JP. Displaced three-and four-part proximal humerus fractures: evaluation and management. J AAOS. 2000;8(6):373-382.