肱骨近端骨折(proximal humerus fracture，PHF)是指位于肱骨头关节面至外科颈以远1~2 cm的骨折，约占所有骨折的5％，仅次于髋部和桡骨远端，是第三常见的四肢骨折，其发病率随年龄增加而增长，超过70％发生在60岁及以上的老年人，且与骨质疏松密切相关。肱骨近端骨折的治疗方式受年龄、骨折类型、功能状态等多种因素影响，其手术治疗方式主要包括经皮穿针、髓内钉、钢板螺钉、关节置换等。复杂肱骨近端骨折肱骨头缺血坏死概率极高，老年患者切开复位内固定(open reduction and internal fixation，ORIF)翻修率可高达19％，更适用关节置换术。
关节置换中最早运用的是半肩关节置换术(hemiarthroplasty，HA)，但其预后差异很大，肱骨大结节不愈合、肩袖受损会严重影响术后功能的恢复，这引导我们探寻更好的治疗选择，因此，反置式肩关节置换术(reverse total shoulder arthroplasty，RTSA)开始成功的运用。
RTSA最先用于肩袖关节病、肩关节炎，后来逐渐用于肩关节置换失败后翻修、PHF后遗症的治疗，现在也越来越多的用于三角肌、腋神经功能良好的复杂老年肱骨近端骨折。RTSA能明显缓解疼痛、提高生活满意度，功能预后也逐渐改善，主动活动范围(range of motion，ROM)增加，逐渐成为老年患者复杂肱骨近端骨折的一个重要的治疗手段，是肱骨近端骨折合并严重肩袖损伤、严重骨质疏松的一个较好的解决方案。
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