Abstract:

OBJECTIVE: To summarize the treatment of complicated proximal humeral fracture with artificial shoulder replacement.
METHODS: A computer-based online search of VIP was performed for related articles published between January 1998 and October 2009 with the key words “shoulder joint, prosthesis replacement, proximal humeral fracture”. Articles with high correlation were included, and repetitive studies were excluded. The data were firstly collected, the references of each article were reviewed.
RESULTS: A total of 18 articles were included. The treatment of complicated proximal humeral fracture remains controversial. Early semi-shoulder joint replacement is an appropriate method. Shoulder replacement includes humeral head replacement and total shoulder replacement. Neer and Biligani type are typical artificial humeral head. The fixation patterns of humeral head prosthesis shaft include cemented and cementless. Bone cement includes total bone cement and proximal cement fixation, and cementless includes pressure fixation and compaction bone grafting. Complications following shoulder replacement involve prosthesis instability, nodule heterotopia, heterotopic ossification, prosthesis loosening, periprosthetic fracture, infection and nerve injury.
CONCLUSION: Majority of complications can be prevented by appropriate location of prosthesis, reconstruction of greater and lesser tubercle, and in combination with postoperative rehabilitation treatment.