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4 part proximal humers fa

I was operated for 4 part proximal humerus facture ,but after ,6 weeks I came to know that some part of humerus ball lose its bone part and some implants bolt now exposed internally (because some bone part is washed off)which may cause problem to other bone and muscle and some doctor's is suggesting for hemianthroplasty and some for bone grafting , and some are saying about wrong fixation and we have to undo the surgury and then redo the fixation, need a proper consultant whether to go for surgery
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Pankaj Agrawal
Orthopedist of Superior Extremity 15 yrs exp Mumbai

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Hi dear..shoulder is one of most complicated joint ib human body.reconstruction of anatomy and normal biomechanics of shoulder joint us essential part of surgery..you require a revision urgently if xrays are to be beleived.will require 2 things..a 3d ct reconstruction and mri if implants are of titanium.then only plan of action can be taken...go after proper prepation into revision surgery..otherwise movements may be restricted with painful outcomes in case of arthritic shoulder..regards dr pankaj agrawal .shoulder knee and joints reconstruction surgeon ahmedabad.
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Dr. Biswajit Dutta Baruah
Orthopedist 13 yrs exp Chennai

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Thanks for asking me to respond. It appears from the x-rays that the screws in the ball of the humerus are longer and protruding beyond the bone. This will certainly damage the cartilage and the socket on other side of the ball. In my opinion, a redo fixation can be done. All attempts to preserve the natural bone must be made before resorting to replacement, especially at the age of 29 years
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Ideally you should visit another surgeon who's willing to do removal of the implants and do a redo fixation of the fracture fragments.
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If screw purchase is of concern, them fixation can be augmented with biocomposites. There is an increased risk of AVN developing either way.
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