Numerous sequelae are reported after treatment, conservative or surgical, for proximal humerus fractures, which may result in shoulder pain and disability. The treatment of these conditions is still controversial. The aim of the present study was to evaluate the results achieved with the use of non-constrained shoulder prostheses. Twelve patients (seven men, five women) were included in the study. The indications for prosthetic shoulder replacement were pain and loss of function that did not respond to medical and physical therapy. All the patients were clinically evaluated preoperatively and postoperatively with the Constant scoring system and by X-ray. Fracture sequelae were grouped in type A, humeral head collapse (n=5); type B, locked fracture/dislocation (n=3); type C non-union of the surgical neck (n=2); and type D malunion of the tuberosity (n=2). In all the patients the same prosthetic implant (Aequalis, Tornier, France), and the same post-operative rehabilitation programme were employed. The mean follow-up was 4 years. The best results were observed in the sequelae grouped as type A and B with an impressive reduction in pain and good recovery of activity. At the last follow-up no radiological signs of implant mobilisation were registered. In our small series shoulder replacement seems to be the treatment of choice, in particular for sequelae of intracapsular impacted fractures of the proximal humerus. A larger series and a longer follow-up are still required to clarify these results.
