Cementless Artificial Humeral Head Replacement for a Comminuted Proximal Hume ral Fracture

Abstract

[Purpose] Open reduction for proximal humeral comminuted fractures and fracture dislocations are often difficult to perform. We have been performing cementless artificial humeral head replacements in such cases, and wish to report our investigations, including the literature studies.
[Patients] From 1993 to 2000, cementless artificial humeral head replacement on 11 patients were performed. The patients ranged in age from 58 to 80 years old with an average age of 76. The patients were l male and 10 females. In 3 cases, the artificial joints used were short stem type and in 8 cases, they were medium stem type, both types using alumina-ceramics head Physio-shoulder system by Kyocera, Japan.
[Results] Active exercises were started average 4days after the operation when pain at rest was relieved. External rotation was permitted in the 3rd week. Fase washing and shampooing were possible in all cases, and pain in the shoulder joint was almost unnoticeable.
[Conclusion]As Neer reported, the artificial humeral head replacement for the shoulder joint has been practised in Japan. In total 11 cases were treated. Although the number is small, we consider that when an elderly patient expects early functional recovery, dislocation fracture and comminuted proximal humeral fracture of 3 parts or more should be treated with an artificial humeral head replacement, in order to improve ADL as soon as possible.