Objective To investigate the clinical value and relating problems in treating complex fractures of proximal humerus by using replacement of humeral head prosthesis. Methods There were 23 cases (10 males and 13 females, age range 43-76 years, mean 58.6 years) with complex fractures of proximal humerus. According to Neer classification, 4 cases had three-part fracture, 17 four-part fracture, 2 cleavage fracture of humeral head, 18 fresh fracture (within 2 weeks after injury) and 5 old fracture, which were all treated with replacement of humeral head prosthesis. Results Follow-up study for a mean period of 15.6 months was conducted in all the cases. No flexible prosthesis, prosthesis dislocation, infection, nerve damage or periprosthesis fractures occurred. According to scoring system modification for hemiarthroplasty (SSMH) of UCLA (Los.Angeles, California, USA), the average score was 26.3. Score was above 27 (excellent) in 3 cases and 24-27 (good) in 18 with an excellence rate of 91.3%, score was 18-24 (moderate) in 2 but no one had score less than 18. Average score was 9.5 in pain, 8.6 in function and 8.2 in muscle power and motion in 23 cases. Conclusions Replacement of humeral head prosthesis is a preferable method for treating the complex fractures of proximal humerus, with significant effect in relieving the pain in the shoulder joint posterior to trauma. It is key to a satisfactory curative effect to correctly select the indication, clearly master the local anatomy, grasp the operation technique and give early and reasonable postoperative rehabilitation treatment.

Objective To evaluate the clinical results of the PCL-retaining total arthroplasty in treatment of knee osteoarthris with valgus.Methods From June 2002 to January 2005,8 cases of osteoarthris with valgus knee were treated with PCL-retaining total knee replacement.The X-ray before operation showed average 21.6 degrees(ranging from 10 to 35 degrees) valgus.The cases were follow-uped from 6 to 36 months,each of them was evaluated with the Special Surgery Knee Scoring System.Results The X-ray after operation showed average 5.7 degrees(ranging from 3 to 9 degrees) valgus.The average HSS scores increased from preoperative 54 to postoperative 91.The range of motion was significantly improved from preoperative 83 degrees to postoperative 118 degrees.All of the cases were no pains after operation,and the function of knees were apparently improved.Conclusions The preliminary clinical results are quite satisfactory for the PCL-retaining total arthroplasty in treatment of osteoarthris with valgus knee.The adequate relaxing and balancing of soft tissue is the key factor to the success of total knee arthroplasty.The follow-up is necessary for further long-term outcome.