Management of Humeral Head Fractures with a Trauma Shoulder Prosthesis: Correlation Between Joint Function and Healing of the Tuberosities

This prospective follow-up study investigated the correlation between healing of the tuberosities and the functional outcome after arthroplasty with a trauma shoulder prosthesis in elderly patients with non-reconstructible humeral head fractures. Surgery was performed on 65 patients (66 shoulders) with a mean age of 74.9 years. A total of 56 patients (57 cases) underwent clinical and radiological evaluation after a mean follow-up of 16 months (range: 4 to 62). Mean Constant Score was 50 and the age- and gender-corrected value was 73%. The Constant Score was significantly higher (62 points, p = 0.015) if the tuberosities healed. Mean ASES index was 68 and correlated significantly with the Constant Score (r = 0.77). Healing of the tuberosities appears to be crucial to achieve good function in patients treated with a humeral head prosthesis. For elderly patients, the main objectives are to recover the ability to perform activities of daily living, to become pain free, and to reach a high level of satisfaction. All these criteria were largely achieved by the procedure described in this paper.