Humeral head replacement
for severely displaced fractures of the proximal humerus was introduced in the 1950s.
Functional outcome after humeral head replacement
for acute three- and four-part proximal humeral fractures.
Bishop J, Flatow E 2005 Humeral head replacement versus total shoulder arthroplasty: clinical outcomes--a review Journal of Shoulder & Elbow Surgery 14 (1) 141S-6S
Radnay C, Setter K, Chambers L et al 2007 Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: a systematic review Journal of Shoulder & Elbow Surgery 16 396-402
Even after a week in the hospital for a humeral head replacement
, months in physical therapy, and continued treatment from some excellent physicians, I continue to have problems as the result of nerve damage to the area.
All inferior osteophytes are removed, and the humeral head is either reamed for resurfacing or cut for humeral head replacement (Fig.
These data lead to an overall success rate of 100% for subscapularis repair following humeral head replacement using a minimally invasive subscapularis-sparing approach.
A humeral head replacement
(hemiarthroplasty: either stemmed or resurfacing) has good outcomes for pain relief, but poor functional recovery.
Literature review (5-25) has shown that in managing the fractures of proximal humerus, although various options like closed reduction and percutaneous pin fixation, open reduction and internal fixation or Humeral head replacement
are available, closed reduction and percutaneous pinning should be reserved for physiologically young and motivated individual with two part fractures and also in minimally displaced three part fractures.
Previous authors have described using the intact humeral anatomic neck to maintain the patient's own inclination and version of the humeral head replacement
Gallinet and associates (9) and Sirveaux and coworkers (13) compared humeral head replacement
(HHR) and rTSA for fractures of the proximal humerus and concluded that the rTSA group demonstrated a more reliable restoration of function above shoulder level than the HHR group.
Although humeral head replacement
usually provides for adequate pain relief, the literature defines quite varied results with respect to functional outcomes.