Our Summary

This research paper discusses the various treatment options available for fractures in the upper part of the humerus bone, which is close to the shoulder. These options include non-surgical treatments, surgical fixation using different types of screws, plates, rods or sutures, and joint replacement surgeries. The best treatment option depends on the specific characteristics of the fracture, such as the number of broken parts and the involvement of the humerus head and the glenoid (the socket part of the shoulder joint). The patient’s overall health, function, and their goals after surgery also play a role in determining the best treatment. The authors note that while the use of hemiarthroplasty (a type of joint replacement surgery) for severe fractures has decreased, they believe it still has a role in treatment.

FAQs

  1. What are the treatment options available for proximal humerus fractures?
  2. How do the characteristics of the fracture and the patient’s functional status influence the choice of treatment?
  3. What are the indications for using hemiarthroplasty as a treatment for severe proximal humerus fractures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about shoulder replacement is to follow the prescribed rehabilitation plan diligently. Physical therapy and exercises are crucial for regaining strength, range of motion, and function in the shoulder after surgery. Consistent participation in rehabilitation can help ensure a successful outcome and a faster recovery.

Suitable For

Patients who are typically recommended for shoulder replacement surgery include those with severe proximal humerus fractures that cannot be effectively treated with nonoperative management or other surgical techniques. These patients may have complex fractures involving multiple parts of the humerus, as well as fractures that involve the humeral head and glenoid. Additionally, patients who have significant functional limitations and desire to regain shoulder function may benefit from shoulder replacement surgery. Ultimately, the decision to recommend shoulder replacement surgery is based on individual patient factors, including fracture characteristics, functional status, and postoperative goals.

Timeline

Before shoulder replacement:

  • Patient experiences shoulder pain, stiffness, and limited range of motion due to arthritis, injury, or other conditions
  • Patient undergoes a thorough evaluation by a healthcare provider, including physical examination, imaging studies, and discussion of treatment options
  • Decision is made to proceed with shoulder replacement surgery based on the severity of symptoms and the patient’s overall health and goals for postoperative function

After shoulder replacement:

  • Patient undergoes preoperative preparation, including medical evaluation, education about the procedure, and physical therapy to optimize shoulder function before surgery
  • Shoulder replacement surgery is performed, typically involving the removal of damaged joint surfaces and replacement with artificial components
  • Patient undergoes postoperative rehabilitation and physical therapy to regain strength, range of motion, and function in the shoulder
  • Patient may experience temporary pain, swelling, and stiffness in the shoulder, but these symptoms gradually improve with time and rehabilitation
  • Patient gradually returns to normal activities and may experience improved shoulder function and reduced pain compared to before surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with shoulder replacement surgery?
  2. How long is the recovery process after shoulder replacement surgery?
  3. What type of shoulder replacement surgery is recommended for my specific condition?
  4. How long can I expect the shoulder replacement to last?
  5. Will I need physical therapy after the surgery, and if so, for how long?
  6. What restrictions or limitations will I have after the surgery?
  7. What is the success rate of shoulder replacement surgery for patients with similar conditions?
  8. How will my pain be managed after the surgery?
  9. Are there any alternative treatments or therapies that I should consider before opting for shoulder replacement surgery?
  10. What is the expected outcome and level of function after shoulder replacement surgery?

Reference

Authors: Schultz BJ, Lowe DT, Egol KA, Zuckerman JD. Journal: J Orthop Trauma. 2021 Aug 1;35(Suppl 2):S3-S4. doi: 10.1097/BOT.0000000000002158. PMID: 34227587