[Decision-making process between plate osteosynthesis vs. endoprosthesis in proximal humerus fractures of the rheumatoid arthritis shoulder].

Abstract

The shoulder joint is involved in a high percentage of rheumatoid arthritis (RA) cases. At the same time, patients with RA develop osteoporosis at an early stage, which significantly increases the risk of fracture. In recent years, joint-preserving procedures with stable-angle implants have become available for individuals with low disease activity and good medication control. However, this approach is dependent on the fracture morphology and, if not adequately addressed, is associated with a high rate of revision surgery. In rotator cuff reconstruction, recent data show encouraging results regarding regenerative capacity, which does not necessarily indicate immediate reverse shoulder arthroplasty. Follow-up treatment must consider delayed osseous healing.