The role of reverse shoulder arthroplasty in proximal humerus fracture treatment and surgical technique

Abstract

Proximal humeral fractures are a common issue in aging populations and surgical treatment indications are still controversial. In the 1950's, primitive designs of plate fixation were approached with suspicion and arthroplasty took its place among the treatments due to the unsuccessful results of osteosynthesis in comminuted fractures and fracture-dislocations. Hemiarthroplasty was widely used for these complicated cases, but due to the age of these population, rotator cuff deficiency and tubercle union problems were encountered and hemiarthroplasty results, which needs the rotator cuff to function, were at best ''unpredictable''. Reverse shoulder arthroplasty, which is designed to be used in arthropathies due to rotator cuff failure, has helped to overcome tubercle problems in patients who cannot undergo osteosynthesis, and successful results have been obtained with the innovations in its design. Reverse shoulder arthroplasty, which is now preferred especially in patients with osteoporosis, high risk of humeral head avascular necrosis, comminuted fractures or fracture dislocations, can provide satisfactory results in patients with high expectations.