Proximal humeral hemiarthroplasty

Summary

Limited evidence from one small quasi-randomized controlled trial and one retrospective cohort study suggests that tuberosity fixation with cable wire and autogenous bone grafting may result in better functional outcomes compared with nonabsorbable suture fixation of the tuberosity when hemiarthroplasty is used for treatment of proximal humerus fractures (three- or four-part). Both radiographic and functional outcomes were consistent across the two different quality studies, with fewer prosthesis migrations, tuberosity dislocations and resorptions, and better Constant-Murley shoulder scores with the cable-wire fixation technique. A multicenter trial or larger, methodologically rigorous randomized controlled trials are needed in order to estimate a true relative risk reduction with the use of cable wire for tuberosity fixation.