Tuberosity-overlapping fixation of the humeral shaft in humeral head replacement surgery

Takaaki Hiranaka, Keiichiro Nishida, Taizo Konishiike, Toshifumi Ozaki, Motohiko Mikasa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorable compared to the reported results of the conventional anatomical reduction technique for bone fragments.

Original languageEnglish
Pages (from-to)299-305
Number of pages7
JournalActa medica Okayama
Issue number4
Publication statusPublished - 2019


  • Bone union of tuberosities
  • Cable wire
  • Cementless stem
  • Humeral head replacement
  • Tuberosity-overlapping technique

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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