Periprosthetic humeral fractures associated with reverse total shoulder arthroplasty: incidence and management.

Abstract

PURPOSE:

The purpose of this study was to record the incidence and management of periprosthetic humeral fractures (PHF) using reverse total shoulder arthroplasty (RTSA) in our institution.

METHODS:

We performed a retrospective study of 203 RTSA implanted in 200 patients between 2003 and 2014. The mean follow-up was 78.82 months (range, 12-141). Mean age of the study cohort was 75.87 years (range, 44-88). There were only 25 male patients (12.5 %). We assessed the presence of periprosthetic humeral fractures studying the medical files and X-rays of all patients.

RESULTS:

We identified seven periprosthetic humeral fractures in 203 RTSA (3.4 %): three intra-operative (1.47 %) and four post-operative (1.97 %). The average age at the time of the fracture was 75.14 years (59-83). All patients were women (100 %). Three patients with post-operative fractures type B were treated by osteosynthesis, and one patient with post-operative fracture type A was treated conservatively. All intra-operative fractures needed cerclage wire and in one case long cemented stem. All our periprosthetic fractures healed.

CONCLUSIONS:

Surgical treatment with osteosynthesis in type B post-operative fractures with a stable stem is recommended. Conservative treatment is sufficient in non-displaced type A post-operative fracture. Special attention should be paid to bone quality patients using non-cemented stems in primary surgery but especially in revision shoulder surgery.

• Authors: Carlos García-Fernández, Yaiza Lópiz-Morales, Alberto Rodríguez, Luis López-Durán, Fernando Marco Martínez
• Journal: International orthopaedics (Int Orthop) Vol. 39 Issue 10 Pg. 1965-9 (Oct 2015) ISSN: 1432-5195 [Electronic] Germany
• PMID: 26318881 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement (adverse effects)
• Cohort Studies
• Female
• Fracture Fixation, Internal
• Humans
• Humeral Fractures (epidemiology, etiology, surgery)
• Incidence
• Joint Diseases (surgery)
• Male
• Middle Aged
• Periprosthetic Fractures (epidemiology, etiology, surgery)
• Reoperation
• Retrospective Studies
• Shoulder Injuries
• Shoulder Joint (surgery)