Early surgeon experience with a fracture-specific humeral stem for proximal humerus fractures: a multicenter survey of predominantly reverse shoulder arthroplasty cases with an illustrative case.

BACKGROUND

Shoulder arthroplasty has become an established treatment option for displaced and complex proximal humeral fractures, particularly in elderly patients. Fracture-specific stems are increasingly used in clinical practice; however, early data on surgeon experience with newly introduced convertible stem designs remain limited. This study aimed to assess orthopedic surgeons' early intraoperative experience with a newly developed humeral fracture system (Tornier Perform Humeral System - Fracture, Tornier Inc., a wholly owned subsidiary of Stryker, Bloomington, MN, USA) using a structured survey as part of an early product surveillance program.

METHODS

A prospective observational survey was conducted among orthopedic surgeons in the United States and Canada who had performed surgery using the fracture stem. Case-level evaluations of intraoperative handling, technical features, and surgeon-reported comparisons with routinely used implant systems were collected. Descriptive statistics were used to summarize survey responses.

RESULTS

Twenty-six orthopedic surgeons submitted feedback on 47 surgical cases (45 primary cases, 2 revisions), including predominantly reverse configurations (46/47) and one hemiarthroplasty construct. All available stem fixation methods were used: cementless without interlocking screws (n = 24), cementless with interlocking screws (n = 14), and cemented (n = 9). Surgeons reported high levels of satisfaction and favorable ratings for ease of use. Across multiple comparative dimensions, the fracture system was frequently rated favorably compared with surgeons' routinely used systems. Twenty-five of 26 participating surgeons indicated that they would consider using the system in future cases and would recommend it to others (missing data for one surgeon). Qualitative feedback described perceived benefits related to specific design features, including press-fit capability, bone graft window, proximal stem design, and the option for interlocking screw fixation.

CONCLUSIONS

Surgeons reported favorable early intraoperative impressions of this fracture system. These findings provide exploratory insights into surgeon-reported usability and perceived design characteristics under early real-world use. Further studies are required to evaluate the clinical relevance of these surgeon-reported perceptions.

LEVEL OF EVIDENCE: IV.