Outcomes of shoulder hemiarthroplasty in non-salvageable proximal humerus fracture: A prospective study

Abstract

Background: Proximal humerus fractures are 5% of all fractures and 80% of all humerus fractures in elderly. Arthroplasty is generally reserved for comminuted Neer”s 3 or 4 part fractures, head split fractures or fracture with significant underlying arthritic changes. The aim of the study is to analyse clinical, radiological and functional outcome of shoulder hemiarthroplasty in non-salvageable proximal humerus fracture.Materials and Methods: This prospective study was carried out in 20 cases of non-salvageable proximal humerus fracture aged above 50 years irrespective of sex. Standard Modular cemented prosthesis were used in all 20 patients. The study was conducted for a period of 15 months and cases were followed up for a period of 6 months.Results: The average age of patient was 62 years with 12 female and 8 were male. Anterior Deltopectoral approach was used as the standard approach for hemiarthroplasty. Modular Hemiarthroplasty prosthesis was inserted with cement. 13 of the 20 patients has shown good results. The range of movement in all 17 patients are satisfactory except for 3 who had poor results but had satisfactory relief of pain. In 3 patients the greater tuberocity failed to unite.Conclusion: Outcome of Hemiarthroplasty is quite satisfactory in elderly if done for fresh traumatic non salvageable proximal humerus fracture without involvement of glenoid and without any unrepairable major rotator cuff injury. Hemiarthroplasty if done within 2 weeks gives better results as there will be less adhesion of soft tissue thus soft tissue repair and their reattachment can be done meticulously. Hemiarthroplasty shoulder done for non-salvageable proximal humerus fractures will provide better stability, early mobilization, lesser stiffness and satisfactory range of motion (ROM) in elderly.