Journal of Musculoskeletal Trauma

Original Articles

Clinical and radiographic outcomes of hemiarthroplasty for proximal humeral fractures in Korea with three or more years of follow-up: a retrospective cohort study: Sang Jin Cheon, Kyu-Hak Jung, Min Hyeok Choi, Suk-Woong Kang; Received October 27, 2025 Accepted December 8, 2025 Published online February 26, 2026; DOI: https://doi.org/10.12671/jmt.2025.00325 [Epub ahead of print]

Abstract PDF: Background
Shoulder hemiarthroplasty (HA) is an established treatment option for complex proximal humeral fractures, particularly in cases involving severe comminution or osteoporotic bone. This study investigated the clinical and radiographic outcomes of HA with a minimum follow-up of 3 years and aimed to identify prognostic factors associated with postoperative function.
Methods
We retrospectively reviewed 44 patients (16 males and 28 females; mean age, 61.2 years; range, 23–83 years) who underwent shoulder HA for complex proximal humeral fractures between 2005 and 2018. The mean follow-up duration was 70.4 months (range, 36–168 months). Clinical evaluations included the Constant score, visual analog scale pain score, patient satisfaction, and range of motion. Radiographic assessments examined tuberosity healing, radiolucent lines, acromiohumeral distance (AHD), and glenoid arthrosis.
Results
At the 3-year follow-up, 64% of patients reported being satisfied or very satisfied. The mean Constant score was 46.6 (range, 13–71), and the age- and sex-adjusted Constant score was 53.5 (range, 19–92). Radiographically, 23% of patients demonstrated radiolucent lines, and 41% showed evidence of glenoid arthrosis. Tuberosity absorption occurred in 39% of patients, with a mean onset of 11.2 months postoperatively, and was significantly associated with lower Constant scores and reduced range of motion. Patients younger than 60 years demonstrated better functional outcomes and lower rates of tuberosity absorption. The mean AHD decreased from 8.4 mm postoperatively to 4.4 mm at the 3-year follow-up (P<0.001).
Conclusions
Shoulder HA for complex proximal humeral fractures yielded satisfactory pain relief and functional outcomes, particularly when tuberosity healing was preserved. However, elderly patients with diminished bone quality were more likely to develop tuberosity absorption and experience poorer functional recovery. Meticulous surgical technique and careful postoperative surveillance remain essential to achieving optimal results. Level of evidence: III.

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The Efficiency of Radiation Shielding Sheet to Reduce Radiation Exposure during C-arm Fluoroscopy: Hosang Jeon, Won Chul Shin, Hee Yun Seol, Yongkan Ki, Kyeong Baek Kim, Ki Seok Choo, Sang Don Lee, Suk-Woong Kang; J Korean Fract Soc 2023;36(4):111-117. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.111

Abstract PDF: Purpose
This study evaluates the radiation shielding performance of a new lead-free tungsten-based sheet to reduce the radiation exposure of operators and patients under C-arm fluoroscopy.
Materials and Methods
A non-lead radiation shielding sheet (ROO201128; Pentas, Korea) was fabri-cated using tungsten and bismuth. The dose measurements were conducted using a C-arm fluoroscopy machine at 64 kVp and 1.5 mA, assuming two possible scenarios according to the position of the sheet. In each scenario, measurements were conducted at three distances (30, 60, and 90 cm) away from the beam center and in three directions (cephal, caudal, and operator’s direction).
Results
In the area within a radius of 60 cm from the beam center, the measured doses were reduced by 66.3% on mean, and the doses measured at distances more than 60 cm were less than 0.1 mSv/h in both scenarios. The most beneficial utilization of the lead-free shielding sheet was verified during C-arm fluoroscopy by placing the sheet on the X-ray tube. The operator’s radiation exposure was reduced by 56.6% when the sheet was placed under the phantom, and by 81.0% when the sheet was placed on the X-ray tube.
Conclusion
The use of lead-free radiation shielding sheets under C-arm fluoroscopy was effective in reducing radiation exposure, and the most beneficial scenario in which the sheet can be utilized was verified when the sheet was placed on the X-ray tube.

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