The continuing role of hemiarthroplasty in the treatment of proximal humerus fractures

Three- and four-part proximal humerus fractures may be successfully managed with non-operative or operative treatment. When surgery is indicated, younger patients with proximal humerus fractures commonly undergo open reduction and internal fixation, while older patients are often treated with reverse shoulder arthroplasty. However, for the active, older patient with a fracture that cannot be reliably reconstructed, hemiarthroplasty remains a viable treatment option. The orthopedic surgeon must carefully review each patient's overall clinical picture and select the treatment technique with the most advantageous risk/benefit profile for that individual.