Medial reconstruction technique in the treatment of complex fractures of humeral proximal epiphysis with SMR prosthetic modular system.

Prosthetic treatment of complex fractures of humeral proximal meta-epiphysis is a very complex surgery that often does not lead to satisfactory results. Indeed, although in the last 35 years since Neer's studies some progress has been made in the knowledge of the anatomy of humeral meta-epiphysis proximal portion, surgical technique and prosthetic design, in the literature we find non-homogeneous experiences regarding the clinical-functional results. At the same time, such experiences agree as far as pain relief is concerned. We report our experience in the treatment of complex fractures of humeral proximal epiphysis with SMR (Lima Lto, San Daniele, Italy) prosthetic system, using our surgical technique of anatomical reconstruction, starting from the medial neck. The case histories, 35 patients, 30 women and 5 men, aged between 56 and 79, were reported in the observation period between April 2000 and February 2005. In 20 cases the right shoulder was treated and in 15 the left one. At the follow-up the patients were assessed clinically by the average Constant Score and also by X-rays and CT scan in order to measure the prosthesis height, its off-set and retroversion.