Hemiarthroplasty for Four-Part Fractures of the Proximal Humerus

Hemiarthroplasty is a time-tested and valuable tool in a surgeon's armamentarium for the treatment of complex fractures of the proximal humerus. Hemiarthroplasty has been shown to reliably relieve pain; functional outcomes are less predictable. Hemiarthroplasty is demanding, and meticulous attention to detail is required for a successful outcome. Reconstruction of proximal humeral anatomy via the restoration of humeral height, version, and alignment is the foundation of the operation. However, tuberosity repair is arguably the most important part of the procedure. Tuberosity malposition and malunion is the most common and significant cause of poor functional outcomes. This article reviews the technique of hemiarthroplasty for fractures of the proximal humerus.