Outcome of cemented Neer II hemiarthroplasty in displaced humeral head fractures

The functional and radiological outcome of cemented Neer II hemiarthroplasty performed within six weeks after a fracture-dislocation or a three/four-part humeral head fracture was evaluated in 48 patients with an average age of 73 years (range: 45 to 89), with an average follow-up period of 44 months (range: 6 to 106). Thirty-two (67%) patients were satisfied or very satisfied. Twenty-nine (61%) patients had no or mild pain, 17 (35%) had moderate pain and two (4%) had severe pain. Constant Score averaged 49 (range: 8 to 71) compared to 78 (range: 40 to 100) for the nonoperated shoulder (p < 0.001). The 26 (57%) patients with abnormal radiographs (malpositioning or loosening of the prosthesis, non-union of tuberosities, heterotopic ossification, and/or glenoid erosion) had a significantly lower Constant Score (45 [range: 8 to 69] versus 55 [range: 31 to 71], p = 0.013). The functional outcome is disappointing and related to the radiographic status. The patients however seem to be satisfied despite a rather stiff shoulder and in our opinion a non-acceptable pain relief.