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Surgical fixation with percutaneous pins
1%
3/212
Surgical fixation with a hemiarthroplasty with tuberosity repair
46%
98/212
Surgical fixation with a total shoulder arthroplasty
22%
46/212
Sling immobilization for 6 weeks followed by active range of motion
8%
17/212
Sling immobilization with daily pendulum exercises
19%
41/212
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The patient has a displaced four-part proximal humerus fracture. Given her age and the presence of osteopenia, a cemented hemiarthroplasty is the treatment of choice. The glenoid is uninjured so a total shoulder arthroplasty is not indicated. Percutaneous pinning in younger individuals with good bone quality may be indicated but not in an 82-year-old woman with osteopenia. Sling immobilization and immediate pendulum exercises will lead to a nonunion. Sling immobilization for 6 weeks followed by active range of motion will result in a nonunion or malunion with unacceptable functional results.
1.6
(29)
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