Proximal Humerus Non Union
Ashish Babhulkar. Acta of Shoulder and Elbow Surgery 2016 Oct – Dec;1(1): 8-13
Non-union proximal Humerus Fractures are complex and the aim of the surgeon should be pain free restoration of function – Functional range of movement & good rotator cuff strength. Pre operative planning in the form of appropriate clinical evaluation, CT scan or other imaging techniques and keeping all options open during surgery is useful. Patients must be counseled about the likely complications since a revision procedure is always fraught with hurdles and obstacles. Careful initial immobilisaiton followed by a supervised, structured rehabilitation programme will help the patient achieve a good result. Patients with cartilage damage and OA and those in the elderly group may be offered a hemiarthroplasty provided there is no infection and the rotator cuff integrity is maintained. When rotator cuff function is compromised and Surgeon is dealing with a frail elderly patient, a Reverse Shoulder Arthroplasty is probably the surgery of choice , provided Deltoid is unaffected.