Wednesday, September 14, 2016

Varus humeral malunion and arthritis - management with a prosthesis in varus

Management of a post traumatic arthritic shoulder can be complicated if the humerus is malunited in varus. 

This is because normal positioning of the humeral component would conflict with the cuff attachment to the tuberosity.

In these cases it is possible to use impaction grafting to fix a small stemmed humeral prosthesis in an amount of varus that matches the deformity, so that the humeral head is positioned in the center of the glenoid. In the case below from yesterday, the fixation of the humeral component was robust - more than what we could have achieved with a humeral resurfacing cap.