Sequelae of Proximal Humeral Fractures

Proximal Humerus Fracture Sequelae (PHFS) are one of the most complex situations to treat in shoulder pathology. It results in articular incongruence, compromised rotator cuff function, and periarticular soft tissue alteration, which leads to shoulder pain and limited range of motion (ROM). Treatment of this pathology should be tailored to the patient’s age and functional level, medical comorbidities, the severity of the deformity, preexisting pathologies, and expectations. Humeral head-preserving techniques are preferred when the articular surface is preserved and the blood supply is intact. Head-replacement techniques are indicated when glenohumeral joint incongruity or degeneration is present and when severe deformity precludes reconstruction. When an arthroplasty is performed, osteotomy of the greater tuberosity should be avoided whenever possible since it is the most relevant prognostic factor in both Anatomic Shoulder Arthroplasty (ASA) and Reverse Shoulder Arthroplasty (RSA). Overall functional outcomes of patients with PHFS initially treated with shoulder arthroplasties are poorer when compared to other etiologies. Complications such as infection and dislocation are more frequent.