Shoulder hemiarthroplasty for complex proximal humerus fracture: Vietnamese experiences

Background: Proximal humerus fracture accounts for 4%-5% of fractures, most of them in older people. For cases of 3-part of 4-part fractures, fracture-dislocation, or comminuted fracture, internal fixation is very difficult to achieve good results. These cases are usually indicated for shoulder joint replacement surgery. The purpose of the study evaluated the results of shoulder hemiarthroplasty surgery in patients with complex proximal humerus fracture. Material and Methods: This prospective study included 30 patients with complex proximal humerus fractures who were treated by shoulder hemiarthroplasty during the period from January 2015 to December 2018. The average follow-up time was 26 months. The results of the surgery were evaluated based on the postoperative range of motion, shoulder Constant score, and the postoperative radiograph. Results: The average postoperative Constant score was 67.65. The active elevation, abduction, internal rotation and external rotation at the last follow-up were 110.2°, 98.6°, 34.5°, and 22.7°, respectively. There were 20 patients (66.67%) without pain, 8 patients (26.67%) with mild pain, and 2 patients (6.66%) with moderate pain. There were 4 patients of nonunion of the greater and lesser tuberosity. There were no complications of dislocation, infection, and stem loosening. Conclusion: shoulder hemiarthroplasty in patients with complex proximal humerus fracture was a safe surgery and had very good results on shoulder function, patients returned to daily activities early.