Background
Displaced comminuted proximal humeral fractures are severe injuries. Operative treatment with retention of the humeral head includes closed or open reduction and external or internal fixation with wires, nails, or plates. We present a series of category 1 patients treated with emiarthroplasty after failed wire fixation of complex proximal humeral fractures.
Patients and methods
Twelve patients with category 1 fracture sequelae of the proximal humerus were treated with hemiarthroplasty. The mean age was 60 years. These complex fractures were initially fixed with K-wires; thereafter, closed reduction was performed in four patients and open reduction in eight patients. The complications that led to revision surgery were malreduction, dislocation, nonunion, and avascular necrosis. The average time lapse from the initial surgery was 7.92 months.
Results
The mean follow-up was 22.25 months. At 18-month follow-up, the active forward elevation increased from 44.42 to 116.25° and the Constant score improved from 20.58 to 66.17. Shoulder hemiarthroplasty for failed initial surgery was successful in category 1 fracture sequelae, but the results were inferior to those reported after primary hemiarthroplasty.
Conclusion
This should be taken into consideration when choosing a line of treatment for complex fractures of the proximal humerus in the elderly population.