Intramedullary fracture positioning sleeve for proper placement of hemiarthroplasty in fractures of the proximal humerus

Shoulder hemiarthroplasty is a well-recognized treatment for certain complex comminuted fractures of the proximal humerus. It is a technique-sensitive procedure that depends on the surgeon's ability to recreate the proper humeral height and achieve a stable tuberosity reconstruction for best outcomes.We now use an implant-specific polymethylmethacrylate intramedullary fracture positioning sleeve (Biomet Inc, Warsaw, Ind) to recreate the humeral length and version and facilitate tuberosity reconstruction in these difficult surgical reconstructions. Use of this device is technically demanding and depends on precise preoperative radiographic evaluation including scaled bilateral full humerus radiographs. With this device, we have been successful in recreating the proper humeral length in most cases.