Modular shoulder hemiarthroplasty for acute fractures. Surgical considerations

Displaced fractures of the proximal humerus with concomitant comminution, interruption of vascular supply, and articular incongruity often require prosthetic replacement for successful treatment. In these difficult cases, the success of prosthetic replacement is dependent on proper patient selection, appropriate surgical technique, and a well-supervised postoperative rehabilitation program. Careful surgical technique should ensure proper placement of the humeral component at the correct height and version, and proper position and fixation of the displaced tuberosities. Supervised rehabilitation emphasizing early range of motion and strength when the tuberosities have healed improves results. The authors found that a modular design humeral implant allows for improved tensioning of the soft tissues and reconstruction of the tuberosities.