**3. Results**

556 Recent Advances in Arthroplasty

Fig. 18.

Complex displaced three and four-part fractures, fracture-dislocations, and fractures with a humeral head split are at risk for the development of malunion and osteonecrosis, especially after internal fixation. Shoulder hemiarthroplasty or, recently, reverse total shoulder arthroplasty is indicated for the treatment of some of these complex fractures (Voos et al 2010).

In spite of advanced patient age, tuberosity healing can be achived by reattachment and bone grafting around specific Reverse Fracture prosthesis, according to Boileau et al. Successful peri-prosthetic tuberosity healing is associated with restoration of both active elevation and external rotation (Boileau et al 2010). (Figure 18)
