Early experience with computer-assisted shoulder hemiarthroplasty for fractures of the proximal humerus: development of a novel technique and an in vitro comparison with traditional methods.

Abstract

A computer-assisted technique was developed for treatment of 4-part proximal humeral fractures via a hemiarthroplasty and tuberosity fixation. This was compared with a standard traditional method in 7 pairs of cadaveric shoulders. The computer-assisted technique used preoperative computed tomography data and computer simulations of anatomic characteristics of the contralateral humerus. This allowed accurate anatomic reconstruction by use of an electromagnetic tracking system and real-time intraoperative feedback. Various anatomic measurements were used to quantify the accuracy of the reconstruction. The differences between the intact and reconstructed values were improved with the computer-assisted technique for 5 of 7 characteristics. However, this was statistically significant only for humeral head offset (P < .05). With further investigation and refinement, this technique should allow for a more anatomic reconstruction of the proximal humerus, potentially resulting in improved patient outcomes. The technique may also prove to be a valuable resource for the laboratory training of inexperienced surgical trainees.