A middle aged patient sustained a proximal humeral fracture that was treated elsewhere with a humeral prosthesis as shown below. Note the absence of the greater tuberosity in this reconstruction indicating cuff deficiency.
As a result of this cuff deficiency the humeral head migrated superiorly and the patient developed pseudo paralysis.
A reverse total shoulder was placed, but there was difficulty in clearing the distal cement, so a short stem prosthesis was placed.
The humeral stem loosened.
We revised this arthroplasty using a 6mm diameter long stem prosthesis inserted after drilling the canal with a flexible reamer placed over a bulb-tipped guide wire. The fixation was excellent. Note the slight 'flex' in the prosthetic stem.
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You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
