Aequalis Reversed for Fracture

Aequalis™ Reversed for Fracture

General Information

An Option for Complex Fractures

Successful hemiarthroplasty for fracture requires healing of the tuberosities. When this doesn’t occur, results are universally poor.1 An alternate solution in patients at risk for tuberosity healing, especially in the elderly, is the reversed prosthesis. A reversed shoulder system in these specific cases can offer more predictable results and deliver the best possible outcome for the patient.

Tornier offers the Aequalis™ Reversed Fracture Shoulder Prosthesis, designed specifically for three- and four-part humeral fractures.

Because successful patient outcomes rely on proper fracture healing, surgeons need to rely on a shoulder prosthesis that is specifically designed to address this clinical need. With Tornier’s Reversed Fracture prosthesis, patients can enjoy improved functional results through better tuberosity reduction, and fixation of the tuberosities, along with increased opportunity for osteointegration.

In one study of 38 patients, a greater level of predictability in results was demonstrated when Reversed Total Shoulder arthroplasty was used for proximal humeral fractures.

(Average AAE when patients were treated for proximal humeral fractures with reversed total shoulder arthroplasty and tuberosities did not heal.*)


Hemiarthroplasty for acute fractures can be a viable option; however, consistent results are not always achieved.

REVERSED for Fracture:

More predictable and consistent results in AAE were achieved with reversed for fracture. Better results were correlated with greater tuberosity healing.


Increasing Tuberosity Healing:

A Key to Successful Patient Outcomes

As shoulder fracture treatments have improved, patients have been able to count on more mobility and less pain. A critical factor in achieving optimal results is tuberosity healing for three- and four-part fractures. The primary complication that leads to poor results is healing of the greater tuberosity. When tuberosity healing does not occur, patient outcomes can be compromised.2

Reversed Total Shoulder Arthroplasty for Fracture:

Driving Toward a Predictable, Positive Outcome

Hemiarthroplasty for proximal humeral fractures has remained as a viable treatment choice for years. More recently, the Reversed Total Shoulder Arthroplasty procedure has rapidly gained acceptance for treating more complex humeral fractures. With the reversed approach, more consistent patient results have been observed.


AEQUALIS™ Reversed Fracture stem

  • Low profile metaphysis facilitates anatomical positioning of the greater tuberosities
  • Hydroxyapatite (HA) coating and proprietary grafting window combine to promote tuberosity bone healing
  • Monobloc body eliminates potential for disassembly

Lateralized spacer

  • Optional 9mm spacer allows increase in lateralization and height of the prosthesis

Polyethylene insert

  • Various humeral insert options allow for optimal deltoid tension and implant stability

Glenoid sphere

  • Two sphere diameters offer a taper lock assembly and a recessed locking screw for secure fixation

Glenoid baseplate

  • Press-fit or threaded post option allows for optimal fixation
  • Multidirectional screws allow for proper orientation
  • Long post option addresses glenoid bone loss

Treatment Options

Tornier Reversed Fracture can be adapted to a hemi-prosthesis when:

  • During the primary surgery, the glenoid bone stock appears to be insufficient to bear the implant of the glenoid components
  • Glenoid bone fracture occurs intraoperatively

The stem is also recommended for revision cases where bone quality is compromised.

Long stems also available

  • Stem lengths range from 130mm to 210mm
  • Star shape on distal stem counters rotational forces

Additional Information


1 Edwards, T. Bradley MD, Fondren Orthopedic Group, 2009.

2 Antuna S, Sperling J, Sanchez-Sotelo J, Cofield R. Shoulder arthroplasty for proximal humeral malunions: Long-term results. J Shoulder Elbow Surg 2002;11:1220129

*Data courtesy of D. Molé and F. Sirveaux, Acute Humeral Head Fractures: Reverse Shoulder Arthoplasty, Nancy, France, 2004.