Shoulder Arthroplasty for Fracture: Restoration of the “Gothic Arch”

Shoulder arthroplasty for fracture remains a technically challenging procedure, often with unpredictable clinical outcomes in the reported literature. Consequently, the appropriate management of certain 3- and 4-part fractures and fracture-dislocations of the proximal humerus remains controversial. However, recent advances in our understanding of the intraoperative technical pitfalls with shoulder fracture arthroplasty have created the potential for more reproducible functional results. Restoration of the “gothic arch” of the shoulder girdle combined with anatomic tuberosity reconstruction can make this operative procedure reproducible.