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Updated: Mar 26, 2026
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Primary Joint Replacement in Proximal Humeral Fractures
Christine Voigt1, Helmut Lill2,3
1Department of Trauma and Reconstructive Surgery, Diakoniekrankenhaus Friederikenstift gGmbH Hannover, Hannover, Germany.
Summary
Surgical treatment for proximal humeral fractures is challenging. Joint replacement is indicated for specific fracture patterns and elderly patients, with good functional outcomes achieved through precise surgical techniques and aftercare.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Biomedical Engineering
Background:
- Proximal humeral fractures present significant surgical challenges, with not all types amenable to successful reconstruction.
- Primary joint replacement is indicated for critical fracture patterns and elderly patients with ischemia-predicting criteria.
Purpose of the Study:
- To review the indications, surgical techniques, outcomes, and complications associated with primary shoulder hemiarthroplasty for proximal humeral fractures.
Main Methods:
- Analysis of multicenter studies focusing on surgical treatment of proximal humeral fractures.
- Evaluation of functional outcomes using the Constant Murley Score and range of motion (ROM).
- Assessment of complication rates and survival rates of shoulder hemiarthroplasties.
Main Results:
- Good functional results depend on soft-tissue preservation, secure tuberosity fixation, rotator cuff balancing, and accurate component positioning.
- Average Constant Murley Scores ranged from 56 to 73.5.
- 79% of patients reported minimal pain, with acceptable ROM (41.9% anteversion >90°, 34.7% abduction >90°). Subjective outcomes often exceed objective findings.
Conclusions:
- Primary shoulder hemiarthroplasty can yield good functional outcomes for specific proximal humeral fractures in the elderly, provided meticulous surgical technique and aftercare are employed.
- While complication rates remain a concern, the 10-year survival rate for shoulder hemiarthroplasties is currently reported at 100%.
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