Hemiarthroplasty for severe fractures of the proximal humerus

Twenty-two patients were followed up at a mean of 33 months after hemiarthroplasty for proximal humeral fractures. Of these, 13 underwent surgery within 30 days of injury and 9 after a mean of 13 months. Outcome was assessed by pain, range of motion, function, stability, and strength. Results were comparable to those from specialist centers. Pain relief was the most predictable outcome. Mean active forward flexion was 93 degrees, active external rotation 24 degrees, and internal rotation to L1. Most patients were satisfied with the outcome. The results were better in younger patients. One patient required a revision after 7 years for aseptic loosening. The severity of the fracture and timing of the operation did not appear to have a bearing on the outcome. Technical problems at surgery, greater tuberosity displacement, late rotator cuff rupture, and poorly motivated patients were the main reasons for failure.