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Shoulder Hemiarthroplasty for Fracture

intermediate Level

Primary Indication

Complex proximal humerus fracture in elderly (>70) or poor bone quality

Danger Structures

  • undefined - Variable based on approach
  • undefined - Surrounding operative field
  • undefined - Bone surface
  • undefined - Joint surfaces if applicable

Visual Atlas

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We're currently sourcing high-quality anatomy diagrams for this procedure.

Step-by-Step Technique

1

Deltopectoral approach preserving cephalic vein

2

Identify biceps as landmark, may tenotomy if damaged

3

Retrieve humeral head fragment - use as template and graft

4

Heavy sutures through tuberosity fragments

5

Preserve tuberosity soft tissue attachments

6

Prepare humeral canal - broach to appropriate size

7

Version: 20-30° retroversion (use forearm as guide)

8

Height: proximal extent of pectoralis major insertion as reference

9

Cement stem (for fracture, not primary OA)

10

Reduce tuberosities around prosthetic head

11

Greater tuberosity at fin or 5-10mm below head apex

12

Lesser tuberosity reduced anatomically

13

Heavy non-absorbable sutures: tuberosity to shaft, tuberosity to tuberosity

14

Bone graft (from head) under tuberosities