Arthroplasty for Treatment of Proximal Humeral Fractures

Abstract

The method of choice in the treatment of severe comminuted proximal humeral fractures with dislocated fragments is shoulder arthroplasty. In acute traumatology hemiarthroplasty is usually indicated. The indication is a fracture with a high risk of avascular necrosis of the humeral head and fractures that cannot be reconstructed. The authors describe the type of classification used, surgical technique, complications specific for this region and outcomes. In the conclusion they formulate the basic recommendations for this type of operation.

proximal humeral fractures - shoulder arthroplasty - surgical technique

References

• 1 Codman E A. The shoulder. Thomas Co., Boston 1934
• 2 Cofield R H. Results and complication. revision. In: Morrey BF (ed). Joint replacement arthroplasty. Churchill Livingstone, New York 1991; pp 437-466
• 3 Cofield R H. The shoulder and prosthetic arthroplasty. In: McCollister EC (ed). Surgery of the Muskuloskeletal System. Churchill Livingstone, New York 1990; pp 1585-1586
• 4 Constant R C. Assessment of the shoulder function.  Orthopäde. 1991;  20 289-294
• 5 Constant R C, Murley A HG. A clinical method of the functional assessment of the shoulder.  Clin Orthop. 1987;  214 160-164
• 6 Frich L H, Sojbjerg J O, Sneppen O. Shoulder arthroplasty in complex acute and chronic proximal humeral fractures.  Orthopaedics. 1991;  14 949-954
• 7 Green A, Barnard L, Limbird R S. Humeral head replacement for acute four-part proximal humerus fractures.  J Shoulder Elbow. 1993;  2 249-254
• 8 Habermeyer P, Schweiberer L. Frakturen des proximalen Humerus.  Orthopäde. 1989;  18 200-207
• 9 Hughes M, Neer C S. Glenohumeral joint replacement and postoperative rehabilitation.  Physical Therapy. 1975;  55 850-858
• 10 Kralinger F, Schwieger R, Wambacher M, Farrell E, Menth-Chiari W, Lajtai G, Hübner C, Resch H. Outcome after primary hemiarthroplasty for fracture of the head of the humerus.  J Bone Joint Surg [Br]. 2004;  86 217-219
• 11 Kuner E H, Siebler G. Luxationsfrakturen des proximalen Humerus - Ergebnisse nach operativer Behandlung. Eine AO-Studie über 167 Fälle.  Unfallchirurgie. 1987;  13 64-71
• 12 Meissner A. Operative Therapie der Humeruskopfluxationfraktur bei Erwachsenen. Eigenes Vorgehen und Ergebnisse.  Akt Traumatol. 1987;  17 204-208
• 13 Moeckel B H, Altchek D W, Warren R F, Wickyewicz T L, Dines D M. Instability of the shoulder after arthroplasty.  J Bone Joint Surg [Am]. 1993;  75 492-497
• 14 Neer C S. Displaced proximal humerus fractures. Part I.  J Bone Joint Surg [Am]. 1970;  52 1077-1103
• 15 Neer C S. Prosthetic replacement of the humeral head. Indications and operative technique.  Surg Clin N Amer. 1963;  43 1581-1597
• 16 Neumann K, Muhr G, Breitfuss H. Primärer Kopfersatz der dislozierten Oberarmkopffraktur. Indikation, Technik, Ergebnisse.  Orthopäde. 1992;  21 140-147
• 17 Rees J, Hicks J, Ribbans W. Assessment and management of three- and four-part proximal humeral fractures.  Clin Orthop. 1998;  353 19-29
• 18 Robinson M C, Page R S, Hill R MF, Sanders D L. Primary hemiarthroplasty for treatment of proximal humeral fractures.  J Bone Joint Surg [Am]. 2003;  85 1215-1222
• 19 Rockwood C A, Green D P. Fractures. Part 1. J. B. Lippincott Co, Philadelphia 1975; pp 585-815
• 20 Willems J W, Lim T E. Neer arthroplasty for humeral fracture.  Acta Orthop Scand. 1985;  56 394-395