Shoulder hemiarthroplasty for the treatment of three and four part fractures of the proximal humerus using Comprehensive® Fracture stem.

We looked at the functional outcome of 32 consecutive patients with proximal humeral fractures that required hemiarthroplasty. Functional status was assessed using University of California Los Angeles (UCLA) shoulder end result assessment, simple shoulder test (SST) and American Shoulder and Elbow Society (ASES) shoulder index. Mean age of the patients was 72.2 years and the mean follow-up was 25.3 months. The mean score on UCLA shoulder end result assessment was 24.8, the mean SST score was 7.4 and the mean ASES shoulder index was 67.2. Mean active forward elevation was 85.1°. Patient satisfaction was around 81%. Radiologically, no dislocation, loosening or greater tuberosity pull off was seen. Superior migration of the humeral head was seen in 11 patients (34%). There was no significant difference seen in functional outcome among different genders, age and those who had radiological superior migration of the prosthesis. However, there was a significant statistical difference seen in the functional outcome between patients who had a deficient or a good quality cuff showing that quality of the rotator cuff is an important predicator of functional outcome.