Summary
Limited evidence from one small quasi-randomized controlled trial and one retrospective
cohort study suggests that tuberosity fixation with cable wire and autogenous bone
grafting may result in better functional outcomes compared with nonabsorbable suture
fixation of the tuberosity when hemiarthroplasty is used for treatment of proximal
humerus fractures (three- or four-part). Both radiographic and functional outcomes
were consistent across the two different quality studies, with fewer prosthesis migrations,
tuberosity dislocations and resorptions, and better Constant-Murley shoulder scores
with the cable-wire fixation technique. A multicenter trial or larger, methodologically
rigorous randomized controlled trials are needed in order to estimate a true relative
risk reduction with the use of cable wire for tuberosity fixation.
