Article Details

Introduction: Surgical neck nonunion in the proximal humerus is a rare sequel, it is reported in literature in four types, according to Boileau. In addition, if nonunion is classified as type 3, a prosthetic management would not be indicated; nevertheless, this decision has switched to management with reverse arthroplasty in the last decade in those patients with poor bone quality and high probability of non-healing of the humeral tuberosities.

Methods: Fifty-eight years old male patient presents a clinical picture of eight years of evolution, with sequels of nonunion due to surgical neck fracture of the proximal humerus, with a history of orthopedic management, with functional limitation, pain and pseudoparesis. According to Bouleau classification, this is a category 2 sequel extracapsular type 3. Surgical management was performed with reverse shoulder arthroplasty for proximal reconstruction.

Results: A score of 85 points was obtained on the Constant scale, with functional recovery and no pain.

Conclusion: Management of sequelae of type 3 proximal humerus fracture has been performed in the last 20 years with graft plus osteosynthesis, with good results; but some patients with osteopenia and no good biologicals conditions benefit from the reverse prosthesis management, with more predictable results.

Keywords: Pseudoarthrosis; Arthroplasty replacement shoulder; Shoulder fractures; Proximal humeral fractures