Objective:

To evaluate clinical and patient-reported outcomes and radiologic greater tuberosity healing following a simplified refixation technique in reverse shoulder arthroplasty for proximal humerus fractures.

Approach:

• Study Design: A two-year prospective cohort study conducted at two Swiss hospitals, including patients treated with reverse shoulder arthroplasty using the Global Unite Fracture Reverse System.
• Inclusion Criteria: Patients with acute displaced or dislocated two-, three-, and four-part fractures, and those with failed conservative treatment.
• Exclusion Criteria: Fractures older than six weeks, prior unsuccessful ORIF, failed hemiarthroplasty, and use of prosthetic systems other than the specified one.
• Operative Technique: Standardized procedure using a two-suture construct for greater tuberosity refixation, preserving rotator cuff tissue when possible.

Key Findings:

• Greater tuberosity healing is crucial for optimal outcomes in reverse shoulder arthroplasty.
• The simplified two-suture technique may facilitate better biological conditions for tuberosity ingrowth.
• Anatomical refixation is associated with improved range of motion and lower complication rates.

Interpretation:

The study suggests that a simplified refixation technique may be effective in promoting greater tuberosity healing and improving clinical outcomes in reverse shoulder arthroplasty.

Limitations:

• The study was limited to a specific cohort and may not be generalizable to all patients with proximal humerus fractures.
• Potential confounding factors related to humeral stem fixation were considered but not fully controlled.

Conclusion:

The study evaluated a simplified refixation technique using the Global Unite Fracture Reverse System for proximal humerus fractures.