title: Primary uncemented hemiarthroplasty for severe fractures of the proximal humerus.
abstract: OBJECTIVE
  The purpose of this study is to evaluate a consecutive series of proximally porous-coated hemiarthroplasty for the treatment of severe proximal humeral fractures with special emphasis on aseptic loosening and functional outcome.
  
  
  METHODS
  Observational cohort of a consecutive series of a single prosthetic design.
  
  
  METHODS
  Orthopaedic clinic, nonacademic institutional hospital.
  
  
  METHODS
  All patients (n = 30) treated with hemiarthroplasty for severe fractures of the proximal humerus with informed consent and at least 1 year follow-up were included. Follow-up averaged 37 months (range, 13-62 months).
  
  
  METHODS
  Uncemented proximally porous-coated hemiarthroplasty.
  
  
  METHODS
  We evaluated clinical and radiologic aseptic loosening, Constant score, patient satisfaction and visual analog scale score, range of motion, radiologic parameters such as head-to-tuberosity distance, lateral projection, and lateral offset.
  
  
  RESULTS
  : The overall Constant score was 68 (standard deviation [SD] 18), the mean patient satisfaction 7.1 (SD 1.8), and the average visual analog scale score 3.7 (SD 2.5). We observed no cases of radiographic tilting or subsidence. In 17 cases (57%), radiolucent lines 1.0 mm or less were observed in less than three zones. None of the cases met the criteria for radiographic loosening. No revision was performed for aseptic loosening. The average head-to-tuberosity distance was 7.6 (SD 8.7 mm). We found that traumatic neurologic deficit and head-to-tuberosity distance significantly influenced Constant score. Lateral projection significantly correlated with Constant score, active forward flexion, and abduction.
  
  
  CONCLUSIONS
  Proximally porous-coated hemiarthroplasty is a valuable alternative alongside cemented hemiarthroplasty for the treatment of severe fractures of the proximal humerus. The radiographic finding of increased lateral projection was associated with an improved range of motion.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Elkerliek Hospital, Helmond, The Netherlands. bgcwpijls@hotmail.com
authors.forename: Bart G
authors.initials: BG
authors.lastname: Pijls
authors.forename: Paul H
authors.initials: PH
authors.lastname: Werner
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Eggen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D002484:Cementation; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D017060:Patient Satisfaction; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D020196:Trauma, Nervous System / Q000150:complications / Q000503:physiopathology; D016896:Treatment Outcome