Shoulder arthroplasty for complex proximal humeral fractures

Abstract

Displaced proximal humeral fractures represent less than 4%-5% of all fractures. The management of these fractures varies widely and includes conservative treatment, open reduction with internal fixation and hemiarthroplasty. Even if shoulder replacement has increased exponentially over the past decades for the treatment of these injuries and has been studied in large series, there is no general agreement on the optimal management of these fractures. Therefore, the objectives of this study were to collect and evaluate the scientific evidence supporting the different treatments for complex proximal humeral fractures, with particular attention to the real value of shoulder arthroplasty compared to nonoperative treatment or internal fixation. A literature analysis was performed on the different strategies, to find the best scientific evidences on this topic.