Osteosynthesis and Trauma Care 2002; 10(4): 202-204
DOI: 10.1055/s-2002-39267
Original Article

© Georg Thieme Verlag Stuttgart · New York

Four-Part Fractures of the Humeral Head: Clinical Results of Primary Hemiarthroplasty

C. Ulrich1 , G. Kelsch1
  • 1Unfallchirurgische Klinik am Eichert, Göppingen, Germany
Further Information

Publication History

Publication Date:
26 May 2003 (online)


In 52 patients with 4-part fractures of the proximal humerus, primary prosthetic replacement of the humeral head was performed. The median age of the mainly female group of patients was 77 years. According to the Neer fracture classification, IV/4 and V/4 fractures were predominant. Subjective evaluation of the treatment results yielded good to very good results in 2/3 of the cases according to the Visual Score. The Constant Score median was 59 points (range: 40 -91 points), with our patients achieving better results for the subjective parameters pain and activity than for the objective parameters mobility and strength. Sonographic examination revealed in nearly all patients atrophied rotator cuffs associated with motor disturbance between the gliding layers. As a result of their trauma, 4 patients suffered from a persistent damage of the brachial plexus, in 1 patient a secondary dislocation of the tubercula resulted, and 2 patients developed a deep infection.


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Prof. Dr. med. C. Ulrich

Unfallchirurgische Klinik am Eichert

Postfach 660

73006 Göppingen · Germany

Phone: +49/71 61/64 22 23

Fax: +49/71 61/64 18 12

Email: christoph.ulrich@kae.de