Acta Chir Orthop Traumatol Cech. 2011; 78(6):490-500 | DOI: 10.55095/achot2011/079

Periprosthetic Humeral Fractures after Shoulder and Elbow ArthroplastyCurrent concepts review

S. GREINER*, V. STEIN, M. SCHEIBEL
Center for Musculoskeletal Surgery, Charité Berlin, Berlin, Germany

Due to rapidly increasing numbers of arthroplasty surgeries of the upper extremity, periprosthetic humeral fractures after shoulder and elbow arthroplasty, formerly described as rare, may hence increase in the near future. Therefore the aim of the present work was to give an overview of the existing literature including possible classifications as well as an update on treatment concepts and experiences with own cases.
After a literature research have been done, existing prevalence, classifications and treatment options, mostly described in case series, were processed to create an overview of the existing state of knowledge. Additionally 7 own cases are described in detail to show the different treatment options used at the authors department.
The currently used classification systems take fracture location, angulation and rotation and fixation of the implant into account. Possible solutions for periposthetic fractures of the humerus include conservative management, open reduction and internal fixation for stable prosthesis and long stemmed implants for lose implants as well as the use of additional allo- or autogeneous bone grafting and reverse shoulder arthroplasty in revision cases with rotator cuff dysfunction. After all treatment of periprosthetic humeral fractures after shoulder and elbow arthroplasty remain a challenging problem.

Keywords: periprosthetic fracture, shoulder arthroplasty, elbow arthroplasty, classification, treatment options

Published: December 1, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
GREINER S, STEIN V, SCHEIBEL M. Periprosthetic Humeral Fractures after Shoulder and Elbow Arthroplasty. Acta Chir Orthop Traumatol Cech. 2011;78(6):490-500. doi: 10.55095/achot2011/079. PubMed PMID: 22217401.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AUSTIN, L., ZMISTOWSKI, B., CHANG, E. S., WILLIAMS, G. R.: Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty? Clin. Orthop. Relat. Res., 469: 2531-2537, 2011. Go to original source... Go to PubMed...
    2. BOILEAU, P., KRISHNAN, S. G., TINSI, L., WALCH, G., COSTE, J. S., MOLÉ, D.: Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J. Shoulder Elbow Surg., 11: 401-412, 2002. Go to original source... Go to PubMed...
    3. BOILEAU, P., WATKINSON, D., HATZIDAKIS, A. M., HOVORKA, I., NEER, A.: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J. Shoulder Elbow Surg., 15: 527-540, 2006. Go to original source... Go to PubMed...
    4. BOYD, A. D., THORNHILL, T. S., BARNES, C. L.: Fractures adjacent to humeral prostheses. J. Bone Jt Surg., 74-A: 1498-1504, 1992. Go to original source...
    5. CAMPBELL, J. T., MOORE, R. S., IANNOTTI, J. P., NORRIS, T. R., WILLIAMS, G. R.: Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J. Shoulder Elbow Surg., 7: 406-413, 1998. Go to original source... Go to PubMed...
    6. CARROLL, E. A., LORICH, D. G., HELFET, D. L.: Surgical management of a periprosthetic fracture between a total elbow and total shoulder prostheses: a case report. J. Shoulder Elbow Surg., 18: 9-12, 2009. Go to original source... Go to PubMed...
    7. DENARD, A., RICHARDS, J. E., OBREMSKEY, W. T., TUCKER, M. C., FLOYD, M., HERZOG, G. A.: Outcome of nonoperative vs operative treatment of humeral shaft fractures: a retrospective study of 213 patients. Orthopedics. 2010 Aug; 33: DOI 10-3928/ 01477447-20100625-16, 2010. Go to original source... Go to PubMed...
    8. FLURY, M. P., FREY, P., GOLDHAHN, J., SCHWYZER, H. K., SIMMEN, B. R.: Reverse shoulder arthroplasty as a salvage procedure for failed conventional shoulder replacement due to cuff failure-midterm results. Int. Orthop., 35: 53-60, 2011. Go to original source... Go to PubMed...
    9. FRANKLE, M. A., GREENWALD, D. P., MARKEE, B. A., ONDROVIC, L. E., LEE, W. E.: Biomechanical effects of malposition of tuberosity fragments on the humeral prosthetic reconstruction for four-part proximal humerus fractures. J. Shoulder Elbow Surg., 10: 321-326, 2001. Go to original source... Go to PubMed...
    10. GERBER, C., YIAN, E. H., PFIRRMANN, C. A., ZUMSTEIN, M. A., WERNER, C. M.: Subscapularis muscle function and structure after total shoulder replacement with lesser tuberosity osteotomy and repair. J. Bone Jt Surg., 87-A: 1739-1745, 2005. Go to original source...
    11. GOHLKE, F., ROLF, O.: [Revision of failed fracture hemiarthroplasties to reverse total shoulder prosthesis through the transhumeral approach : method incorporating a pectoralis-major-pedicled bone window]. Oper. Orthop. Traumat., 19: 185-208, 2007. Go to original source... Go to PubMed...
    12. GOLDBERG, S. H., URBAN, R. M., JACOBS, J. J., KING, G. J., O'DRISCOLL, S. W., COHEN, M. S.: Modes of wear after semiconstrained total elbow arthroplasty. J. Bone Jt Surg., 90-A: 609-619, 2008. Go to original source... Go to PubMed...
    13. GREINER, S. H., DIEDERICHS, G., KRÖNING, I., SCHEIBEL, M., PERKA, C.: Tuberosity position correlates with fatty infiltration of the rotator cuff after hemiarthroplasty for proximal humeral fractures. J. Shoulder Elbow Surg., 18: 431-436, 2009. Go to original source... Go to PubMed...
    14. HANYU, T., NAKAZONO, K., ISHIKAWA, H.: Humeral shaft fracture after a total elbow arthroplasty. J. Shoulder Elbow Surg., 7: 541-544, 1998. Go to original source... Go to PubMed...
    15. KAMINENI, S., MORREY, B. F.: Proximal ulnar reconstruction with strut allograft in revision total elbow arthroplasty. J. Bone Jt Surg, 86-A: 1223-1229, 2004. Go to original source... Go to PubMed...
    16. KAWANO, Y., OKAZAKI, M., IKEGAMI, H., SATO, K., NAKAMURA, T., TOYAMA, Y.: The "docking" method for periprosthetic humeral fracture after total elbow arthroplasty: a case report. J. Bone Jt Surg. 92-A: 1988-1991, 2010. Go to original source... Go to PubMed...
    17. KIM, D. H., CLAVERT, P., WARNER, J. J.: Displaced periprosthetic humeral fracture treated with functional bracing: a report of two cases. J. Shoulder Elbow Surg., 14: 221-223, 2005. Go to original source... Go to PubMed...
    18. KUMAR, S., SPERLING, J. W., HAIDUKEWYCH, G. H., COFIELD, R. H.: Periprosthetic humeral fractures after shoulder arthroplasty. J. Bone Jt Surg., 86-A: 680-689, 2004. Go to original source... Go to PubMed...
    19. LILL, H., BEWER, A., KORNER, J., VERHEYDEN, P., HEPP, P., KRAUT-HEIM, I., et al.: [Conservative treatment of dislocated proximal humeral fractures]. Zbl. Chir., 126: 205-210, 2001. Go to original source... Go to PubMed...
    20. MEYER, C., ALT, V., SCHROEDER, L., HEISS, C., SCHNETTLER, R.: Treatment of periprosthetic femoral fractures by effective lengthening of the prosthesis. Clin. Orthop. Relat. Res., 463: 120-127, 2007. Go to original source... Go to PubMed...
    21. O'DRISCOLL, S. W., MORREY, B. F.: Periprosthetic fractures about the elbow. Orthop. Clin. North. Am., 30: 319-325, 1999. Go to original source... Go to PubMed...
    22. SANCHEZ-SOTELO, J., O'DRISCOLL, S., MORREY, B. F.: Periprosthetic humeral fractures after total elbow arthroplasty: treatment with implant revision and strut allograft augmentation. J. Bone Jt Surg., 84-A: 1642-1650, 2002. Go to original source...
    23. SANCHEZ-SOTELO, J., WRIGHT, T. W., O'DRISCOLL, S. W., COFIELD, R. H., ROWLAND, C. M.: Radiographic assessment of uncemented humeral components in total shoulder arthroplasty. J. Arthroplasty, 16: 180-187, 2001. Go to original source... Go to PubMed...
    24. STEINMANN, S. P., CHEUNG, E. V.: Treatment of periprosthetic humerus fractures associated with shoulder arthroplasty. J. Am. Acad. Orthop. Surg., 16: 199-207, 2008. Go to original source... Go to PubMed...
    25. TYTHERLEIGH-STRONG, G., WALLS, N., McQUEEN, M. M.: The epidemiology of humeral shaft fractures. J. Bone Jt Surg., 80-B: 249-253, 1998. Go to original source...
    26. WENDA, K.: [In situ connection of a hollow intramedullary nail to the stem of a knee prosthesis in periprosthetic fracture]. Unfallchirurg. 105: 19-22, 2002. Go to original source... Go to PubMed...
    27. WORLAND, R. L., KIM, D. Y., ARREDONDO, J.: Periprosthetic humeral fractures: management and classification. J. Shoulder Elbow Surg., 8: 590-594, 1999. Go to original source... Go to PubMed...
    28. WRIGHT, T. W., COFIELD, R. H.: Humeral fractures after shoulder arthroplasty. J. Bone Jt Surg., 77-A: 1340-1346, 1995. Go to original source... Go to PubMed...

    Return to the content