What is a Reverse Total Shoulder Replacement for Fracture?

1. Nonsurgical treatment – proximal humerus fractures that are less severe and not significantly shifted or displaced can be successfully treated without surgery. Surgery is typically recommended for more complex shoulder fractures unless the patient is not medically able to undergo surgery.

2. Plate and screw fixation – also called an “open reduction and internal fixation,” fixation with a metal plate and screws can sometimes be performed to treat complex, displaced proximal humerus fractures.

3. Hemiarthroplasty for fracture – sometimes a metal prosthetic replacement or hemiarthroplasty can be used. A “hemiarthroplasty” implies that only the humeral side or ball of the shoulder in replaced. Hemiarthroplasty procedures were commonly performed for very complex shoulder fractures prior to the design of reverse total shoulder replacements. Reverse total shoulder replacement for fracture has nearly replaced hemiarthroplasty for fracture, but it is still used in some cases.

4. Reverse total shoulder replacement for fracture – reverse total shoulder replacement for fracture has significantly improved the treatment of complex proximal humerus fractures especially in older patients with osteoporotic bone. The prosthetic ball and socket are “reversed” in a reverse total shoulder replacement. The ability to restore overhead motion and obtain fracture healing with a reverse total shoulder replacement has been promising in early follow-up studies.

Read more here about reverse total shoulder replacement.

Citation: Szerlip BW, Morris BJ, Edwards TB. Reverse Shoulder Arthroplasty for Trauma: When, Where, and How. Instructional Course Lectures. 2016;65:171-80.