Replacement Of Humeral Head Prosthesis For Older Fractures Of Proximal Humerus

Objective To investigate indication, technical key during surgery and early results of humeral head replacement for the treatment of older fractures of proximal humerus. Methods Sixteen patients who received humeral head replacement were reviewed with a mean follow-up period of 18.3 months. Of the 16 patients, all were suffered acute fractures with the mean interval between injury and surgery being 7 days. The mean age for these patients was 75.7 years. X-rays were taken at post-operation,2-week,8-week, 12-week,6-month and the latest follow-up. ASES score, Constant score had been adopted for evaluation at the latest follow-up.Results The mean ASES score was 89.1(64-94); the mean VAS score was 2.7 (0～5); the mean forward flexion was 128.1°(90°～150°), abduction 85°(50°～120°), external rotation 35.0°(30°～40°), internal rotation at level L1(L2～T10); the mean Constant score was 85.7 (53～95); the total satisfaction rate for pain relief was 93.8%, and functional recovery was 87.5%.Conclusions Through strict indication control, appropriate timing, meticulous surgical techniques and long intense rehabilitation, satisfactory results can be obtained in humeral head replacement for the treatment of complicated proximal humerus fractures. But a long-term follow up data is needed for further evaluation.