Aims: Displaced proximal humeral fractures are considered a real challenge. Malunion, nonunion, avascular necrosis, arthritis are frequent complications. Thus revision surgery, using reverse shoulder prosthesis, is mandatory both to restore shoulder function and to relieve pain.

Our purpose was to understand if clinical outcomes after revision surgery are influenced by the first surgical procedure performed to fix the fracture.

Methods: 15 patients, mean age 67±2 yrs, sustained a complex humeral fracture. Group A (8 patients) was treated with reduction and fixation with K-wires, while in Group B (7 patients) a cemented hemiarthroplasty was performed. After primary surgical treatment, both groups required revision surgery and a shoulder reverse prosthesis was implanted.

Constant score, Flexion, VAS scale and Dash questionnaire were evaluated preoperatively and at 1 year after revision surgery,

Results: Constant Score improved from 7 to 42 points in Group A, while in Group B from 15 to 41 points (n.s.). Flexion in Group A improved from 30° to 106°, while in Group B from 44° to 94° (n.s.). VAS value decreased from 9 to 2 in Group A and from 8 to 5 in Group B (n.s.). Dash value decreased from 82 to 49 points in Group A and from 75 to 55 points in Group B (n.s.).

Conclusions: This study demonstrates that reverse shoulder prosthesis offers a salvage-type solution in revision surgery reguardless the surgical treatmet performed previously. In conclusion reverse shoulder prosthesis is an important tool the surgeon can use in shoulder revision surgery.