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Revision open reduction and internal fixation
4%
140/3389
Valgus corrective osteotomy of proximal humerus
2%
60/3389
Shoulder arthroplasty
93%
3161/3389
Shoulder arthrodesis
0%
5/3389
Humeral head resection
6/3389
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Figures A and B show loss of fixation of a proximal humerus fracture. The most appropriate treatment for this scenario is a humeral arthroplasty, as the tenuous blood supply of the proximal humerus is likely chronically disrupted, leading to osteonecrosis and poor healing potential of the proximal humerus. Traditionally, hemiarthroplasty was performed for these presentations, but reverse total shoulder arthroplasty has emerged as a potentially better treatment method, especially if the rotator cuff function/status is unknown or poor. According to the referenced article by Norris et al, delayed shoulder hemiarthroplasty decreased shoulder pain in 95% of patients but warned of technical difficulties and limited postoperative range of motion. A total shoulder arthroplasty is needed if glenoid erosion from the screw(s) or bone occurs.
4.1
(23)
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