Artroplastia reversa no tratamento da pseudoartrose do úmero proximal
DOI:
https://doi.org/10.61443/rto.v24i4.472Palavras-chave:
shoulder/surgery; reverse shoulder arthroplasty; proximal humerus nonunion.Resumo
A artroplastia reversa do ombro foi criada em 1980 pelo cirurgião francês Paul Grammont para pacientes com artropatia do manguito rotador associada à lesão irreparável do manguito. Com o melhor desenvolvimento da técnica cirúrgica e dos implantes outras indicações surgiram: fraturas complexas do úmero proximal, pseudoartrose, revisão de próteses convencionais, instabilidade crônica do ombro, artrite reumatoide ou outras doenças inflamatórias associadas à insuficiência do manguito, e reconstruções após ressecções oncológicas ou falhas de cirurgias prévias. Todavia, são crescentes os casos de complicações pós-operatórias, menor durabilidade e maiores taxas de revisões cirúrgicas, especialmente em pacientes mais jovens ou com altas demandas. Os desafios atuais da artroplastia reversa incluem o afrouxamento da glenosfera, instabilidade protética, durabilidade limitada em pacientes jovens, complicações relacionadas ao deltoide, restrições de movimento, risco de infecções, perda óssea glenoidal ou umeral, dificuldades técnicas em casos complexos e o alinhamento das expectativas dos pacientes com os resultados funcionais. Apresentaremos um relato de caso de uma paciente do sexo feminino, 55 anos, com sequela de fratura do úmero proximal esquero há 2 anos que foi tratada com artroplastia reversa do ombro.
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