Hemiarthroplasty for proximal humerus fractures: Early and late

Hemiarthroplasty has been the preferred surgical procedure for 3- and 4-part proximal humeral fractures. Our retrospective study examined function and radiographic outcomes at 2- and 5-year follow-up in patients who received a hemiarthroplasty for 3- and 4-part proximal humeral fractures. Forty-seven consecutive patients of a single surgeon treated with a shoulder hemiarthroplasty between 2000 and 2006 were examined. Postoperative radiographs were compared with radiographs at 2 and 5 years along with active range of motion and functional outcomes scores. The mean acromiohumeral distance decreased from 10.3 mm postoperatively to 8.5 mm at 2 years and 6.7 mm at 5 years (P ≤ 0.001). More patients had stem osteolysis and tuberosity reabsorption at 2 and 5 years compared with postoperatively (P = 0.16 and P ≤ 0.001, respectively). Multiple measures of functional outcome were obtained and all found to be worse at 5 years than at 2 years. Pain scores increased from 2 to 5-year follow-up (P = 0.018). Hemiarthropasty has a high rate of long-term complications, including decreased acromiohumeral distance, stem osteolysis, and tuberosity reabsorption. Pain scores and functional outcomes worsened. No improvement in range of motion was observed.