2006 - UZ Leuven

of debate. A good pain relief can be predicted but function is notalways a success. A good pain relief can be predicted but function isnot always a success. Because of the good functional results in a cuffdeficient shoulder and the ease of rehabilitation some people doadvocate to use a reversed shoulder prosthesis as primary fracturetreatment.Materials and methods: We did compare a prospective series ofreversed shoulder prosthesis (Delta III Depuy Warshaw) used aprimary shoulder fracture prosthesis to a historical series ofanatomical shoulder prosthesis (Articula Mathys Betlach). 15 patients,matched for sex and age have been included in both groups. Patientshave been scored functionally using the ASES shoulder index and theConstant score. Complications have been documented.Results: Both using the ASES index as the Constant score theAnatomical shoulder prosthesis did score significantly better than thereversed shoulder prosthesis. The number of complications washigher in the reversed shoulder prosthesis group.Conclusion: For the treatment of complex proximal humeral fracturesan anatomical shoulder fracture prosthesis seems to be the treatmentof choice as compared to a reversed shoulder prosthesis. We believethat the fact that there are no cuff remnants attached to the reversedshoulder prosthesis does yield in a poorer outcome as for reversedshoulder prostheses used for rotator cuff arthropathy.NIJS S., HIERNER R., CLAES M., BROOS P.: Defect fractures withsevere soft tissue defect in the polytraumatized. Eur. J. Trauma, 2006;32; 195 (Abstract).Introduction: Complex fractures of the elbow are difficult to treat.When bone defects are combined with severe soft tissue damagetherapeutic options are limited. We describe our treatment results in 7patients with combined bone loss and severe soft tissue defect.Material and methods: Between August 2001 and May 2005 we didtreat 7 patients because of combined articular bone loss of the elbowand severe soft tissue defect. All patients were polytraumatized. Thereare 4 female and 3 male patients. Mean age is 30 years. In 6 patientsa total elbow arthroplasty has been performed. In 3 of them thearthroplasty has been augmented with the use of an allograft. In the7 th patient we did reconstruct the joint using an allograft alone. Tocover the soft tissue defects we did use in every patient a latissimusdorsi muscle flap. In two patients vascular reconstruction of thebrachial artery was necessary. In 4 patients nerve reconstructionshave been performed.Results: Every patient obtained a functional elbow joint. 5 of the sevenpatients were professionally active at the time of injury. 4 of them were123