Stemless total shoulder arthroplasty for a 4-part proximal humerus malunion and post-traumatic arthritis a case report

Case: We present a 62-year-old left-hand-dominant woman with history of renal failure, osteoporosis, and 4-part proximal humerus fracture malunion with subsequent post-traumatic arthritis of the left glenohumeral joint. After conservative treatments failed to relieve her symptoms, the patient underwent stemless total shoulder arthroplasty (TSA) because of concerns that her proximal humerus could not accommodate a stemmed implant. At 2 and a half-years postoperative, the patient demonstrated significant improvement of symptoms without signs of radiographic loosening. Conclusion: In the setting of proximal humerus malunion with post-traumatic arthritis, clinical improvement without implant loosening can be achieved with stemless TSA, even in the setting of compromised bone quality.