This 71 years old female patient came with h/o fall. She is a Diabetic & Hypertensive.

The problems to be tackled in management are.

• 1. Severe Osteoporotic bone, where the screw purchase may not be good.
• 2. Severely comminuted fracture head, where the reduction could be technically difficult.
• 3. 71 years of age.

All the above parameters were considered and it was decided, it would be prudent to do a Primary Hemiarthroplasty of the shoulder joint in this patient. It is one month since surgery & the patient is doing well. The patient was discharged on the 4th day. Pre operative & Post operative x-rays are shown above, will update as the patient comes for follow up.

Literature:

In young individuals primary TSR (Total Shoulder Replacement ) might be a better choice. In older individuals primary Hemiarthroplasty of the shoulder should be considered before a TSR ( Total shoulder Replacement ). Since TSR is a technically demanding and costlier surgery.