[Complex injuries of the proximal humerus treated with humeral head prosthesis. Apropos of 21 cases reviewed after a median 4-year follow-up].

Of a total of 35 complex fractures of the upper humeral epiphysis treated by Neer arthroplasty, 21 were evaluated at a mean of 4 years after operation. The shoulder function according to Constant was 70% of the contralateral one. The internal and external rotations were rarely symmetric. Clinical improvement was possible during the first 2 years. Late breakage and migration of wires used to fix the tuberosities caused failure of this method of fixation. Dynamic radiographs revealed significant gleno-arthroplastic movement and a constant medialization of the prosthetic humerus.