Shoulder Hemiarthroplasty for Proximal Humerus Fracture-Dislocation

This case shows a severe right proximal humerus fracture-dislocation in a 38-year-old male after motorcycle trauma. Imaging demonstrated a displaced surgical-neck fracture with humeral head dislocation, requiring CT-based assessment and individualized operative planning.

Case typeTrauma / complex shoulder reconstruction

Patient38-year-old male

MechanismMotorcycle accident

DiagnosisRight proximal humerus surgical-neck fracture with humeral head dislocation

TreatmentRight shoulder hemiarthroplasty

ImagesDe-identified, logo-watermarked radiographs and operative images

Why this injury is complex

A proximal humerus fracture-dislocation is different from a simple shoulder fracture. The fracture pattern can affect joint congruity, humeral head viability, tuberosity healing, and soft-tissue repair. CT imaging is often required to understand the fragments and the position of the humeral head before deciding on treatment.

Why hemiarthroplasty was selected

In young adults, preservation of the native joint is considered whenever feasible. In selected complex fracture-dislocations, however, hemiarthroplasty may be chosen when fixation of the injured humeral head is not considered the most reliable option after imaging and intra-operative assessment.

In shoulder hemiarthroplasty, the damaged humeral head is replaced while the glenoid side of the joint is preserved. The objective is to restore a stable relationship between the prosthetic humeral head and the glenoid and allow structured rehabilitation.

Radiographic and operative documentation

The following de-identified, logo-watermarked images are presented for patient education and case-library documentation.

Pre-operative X-ray of the right shoulder showing proximal humerus surgical-neck fracture-dislocation — Figure 1. Pre-operative AP X-ray of the right shoulder showing proximal humerus surgical-neck fracture-dislocation.

De-identified CT axial view of right proximal humerus fracture-dislocation — Figure 2. De-identified cropped CT axial views confirming a complex proximal humerus fracture-dislocation.

De-identified CT reformatted view of surgical-neck humerus fracture with head dislocation — Figure 3. De-identified cropped CT reformatted views showing fracture configuration and humeral head displacement.

Intraoperative humeral head and shoulder hemiarthroplasty components — Figure 4. Intra-operative photograph showing the excised humeral head and hemiarthroplasty trial/prosthetic components.

Post-operative X-ray after right shoulder hemiarthroplasty for proximal humerus fracture-dislocation — Figure 5. Post-operative AP X-ray after right shoulder hemiarthroplasty.

Clinical learning points

Fracture-dislocation around the shoulder often needs CT imaging, not plain X-ray alone.
The choice between fixation and arthroplasty depends on fracture morphology, bone quality, humeral head viability, tuberosity status, patient demand, and intra-operative findings.
Post-operative rehabilitation is a core part of recovery and should protect soft-tissue repair and tuberosity healing when relevant.
This case does not mean every proximal humerus fracture needs arthroplasty.

FAQ

Does every proximal humerus fracture-dislocation need hemiarthroplasty?

No. Some injuries can be treated with fixation or other reconstructive strategies. The decision depends on imaging, patient factors, and intra-operative assessment.

Why is CT important in this injury?

CT helps define the number and position of fracture fragments and the relationship of the humeral head to the glenoid, which supports safer surgical planning.

What is shoulder hemiarthroplasty?

It is replacement of the humeral head component of the shoulder joint while preserving the glenoid side.

Is rehabilitation required after surgery?

Yes. A structured rehabilitation plan is essential, but timing and restrictions must be individualized by the treating surgeon and physiotherapy team.

Medical disclaimer: This de-identified case is published for medical education and patient awareness. It does not replace clinical examination, imaging review, or individualized advice by an orthopedic specialist.

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