[Prostheses for fractures of the proximal humerus: presentation of current results of anatomical fracture shoulder prosthesis under consideration of alternative concepts].

BACKGROUND: The purpose of this present study was to review the functional and radiological results of patients with complex fractures of the proximal humerus who were treated with an anatomical shoulder prosthesis. PATIENTS AND METHODS: Between 1999 and 2005 a total of 61 patients were treated with an anatomical trauma prosthesis after an acute fracture.
RESULTS: Thirty-eight patients (31 women and 7 men) with a mean age of 72 (range, 31-85) years could be followed-up. The absolute Constant score averaged 57.7 of 100 (range, 32-86) points by a mean of 86 (range, 60-129) months. Postoperative active elevation averaged 105 (range, 50-180)° and active abduction averaged 96 (50-180)°. Tuberosity resorption was found in 52% (20/38) at final follow-up. The outcome was significantly better in patients with healing of the tuberosities (p = 0.02).
CONCLUSION: With the use of an anatomical trauma prosthesis the reduction of the pain level is excellent while the gain in function is only slight. The bony union of the tuberosities in an anatomical position is essential to achieve good results.