الفهرس 
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Abstract
Rate of total shoulder replacements has risen dramatically throughout the last decades subsequent to expanding indications and its leading outcomes in controlling pain, improving functions and life quality. Proximal humeral bone defects are considered one of the predominant difficulties in reconstructive surgeries which may be due to primary cause such as, (Post. tumour resection, post resection of osteomyelitis and highly comminuted fractures) or prior to failed previous shoulder replacement. Controversy has still existed regarding the ideal reconstructive procedure. In our centre we prospectively report the short-term outcomes proximal humeral reconstruction with modular endoprosthesis.
Methods: a total number of 40 shoulders divided into two main groups, 23 proximal humeral reconstructions and 15 total humeral reconstruction were performed in same centre by single surgeon (17 males and 23 females). In both groups, the Indications for reconstruction showed great discrepancies, 9 patients presented with previous prosthetic infection, 6 septic arthritis, 9 aseptic loosening, 7 fracture sequalae, 4 patients oncology purposes and 7 other cases of revision Prostheses were evaluated radiologically. The outcomes were assessed using DASH score, pain experience, limitations and patient satisfaction.
Results: The mean follow-up period was 33 months with minimum of 7 months. Minor differences have been noticed in follow-up between preoperative and postoperative scoring because of complexity of the cases. In group A: mean pain has been significantly improved from 6.14 preoperatively to 4.9 postoperatively). Mean of shoulder limitation dropped from 8.4± 1.53 to 6.00± 2.85. Patients’ satisfaction found to be in average of 6.3±2. Upper limb disability has been significantly dropped from a mean of 80.63±10.86 preoperatively to 62.27± 21.05 in the final follow-up. P-value (0.001). Major postoperative complications included dislocation in 6 patients which has been managed by linked prosthesis, deep infection, recurrent notching in one patient. Traumatic Periprosthetic fracture occurred in 2 patients which have been managed. No radiological loosening detected throughout the follow-up.
In group B: mean pain has been significantly improved from 7.07 preoperatively to 3.07 postoperatively. Mean of shoulder limitation dropped from 9.3 to 6.2. Patients’ satisfaction found to be in average of 6.4 ±3.8. Upper limb disability has been significantly dropped from a mean of 80.28 ± 12.72 preoperatively to 53.96 ±20.16 in the final follow-up. P-value (0.001).