Outcome after hemiarthroplasty for three- and four-part fractures of the proximal humerus

We reviewed 27 patients who had sustained displaced three- or four-part fractures of the proximal humerus and who were treated with a humeral hemiarthroplasty. Seventeen patients had a three-part fracture, and 10 had a four-part fracture. The mean follow-up period was 39 months (12 to 94 months). All fractures were classified according to Neerʹs classification. The Constant score was used for their follow-up evaluation. The median Constant score at follow-up was 51 for the three-part fractures and 46 for the four-part fractures. The median range of movement for all the patients in flexion was 70°, abduction 70°, internal rotation 50°, and external rotation 45°. Nine patients still had moderate or severe pain. Eight patients had moderate or severe disability. Our results were disappointing, and further studies on open reduction and fixation are therefore justified. (J Shoulder Elbow Surg 1998;7:85-9.)