Treatment of the four-part proxsimal humerus fractures in elderly patients with hemiarthroplasty

Abstract

Objectives: In this study, elderly patients treated by hemiarthroplasty for the four-part proximal humerus fractures were retrospectively evaluated.
Patients and methods: Twenty-eight patients 60 years of age and above who underwent hemiarthroplasty for the four-part humerus proximal shaft fractures between years 1991-2005 were evaluated. The mean age was 67.7 years (61-82). Nine patients were male and 19 patients were female. Cause of fracture in 11 cases was traffic accidents (39.3 %) and in 17 cases it was a simple fall (60.7 %).
Results: The mean follow-up time was 54.5 (26-153) months. Rehabilitation started at the end of the first week of surgery. All the cases were evaluated according to the Neer Scoring System. The mean Neer score was 77.1 (32-92). Results were excellent in 14.3%, adequate in 46.4%, inadequate in 28.6% and unsuccessful in 10.7% of the cases.
Conclusion: Primary shoulder hemiarthroplasty is a preferred treatment method in elderly patients having four-part humerus proximal fractures despite limited excellent results. Presence of osteoporosis, high osteonecrosis risk and difficulties in internal fixation amend the outcome.