Results after primary hemiarthroplasty of dislocated humeral head fractures

Humeral head fractures often lead to a high complication rate because of vu lnerable vascularization of the humeral head, pretraumatical soft tissue le sions and osteoporotic bone. Compared with open reduction and internal fixa tion primary hemiarthroplasty seems to be an encouraging alternative treatm ent in case of dislocated and comminuted fractures. To evaluate our results following primary hemiarthroplasty we examined the outcome of 27 patients treated between November 1993 and May 1997 by primary hemiarthroplasty (15 Neer ii, 12 Aequalis) in our institution within two weeks after trauma. The average patient follow-up was 3.5 years. Postoperatively more than 80 % of the patients reported no pain. Excellent or good results with abduction ov er 90 degrees, low or moderate lass of power and low restraint in activitie s of air day living were achieved in about 50 % of patients. The results ac cording to the criterias of the Constant-Score depended on the intensity of the rehabilitation programme with an average outcome of 65 points. Maybe i n the future functional results can be improved by a more aggressive rehabi litation and stronger rotator cuff refixation.