[Treatment outcome after primary hemi-alloarthroplasty in dislocated humeral head fractures]

Abstract

Humeral head fractures often lead to a high complication rate because of vulnerable vascularization of the humeral head, pretraumatical soft tissue lesions and osteoporotic bone. Compared with open reduction and internal fixation primary hemiarthroplasty seems to be an encouraging alternative treatment in case of dislocated and comminuted fractures. To evaluate our results following primary hemiarthroplasty we examined the outcome of 27 patients treated between November 1993 and May 1997 by primary hemiarthroplasty (15 Neer II, 12 Aequalis) in our institution within two weeks after trauma. The average patient follow-up was 3.5 years. Postoperatively more than 80% of the patients reported no pain. Excellent or good results with abduction over 90 degrees, low or moderate loss of power and low restraint in activities of all day living were achieved in about 50% of patients. The results according to the criteria of the Constant-Score depended on the intensity of the rehabilitation programme with an average outcome of 65 points. Maybe in the future functional results can be improved by a more aggressive rehabilitation and stronger rotator cuff refixation.