Surgically Treated Humeral Shaft Fractures Following Shoulder Arthroplasty

Andersen, Jaron R.; Williams, Christopher; Cain, Richard A.; Mighell, Mark A.; Frankle, Mark A.

doi:10.2106/jbjs.k.00863

Cited by 78 publications

(59 citation statements)

References 16 publications

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“…The risk of late periprosthetic fractures is higher due to the presence of the metal implant as stress riser [13,23,24]. While late traumatic (after a fall) periprosthetic humeral fracture in diaphyseal stem prostheses has to be revised in the majority of the cases and has a negative effect on the results [9,13], in our series most of these fractures were metaphyseal and were treated conservatively with excellent outcome. The mean age of our patients was 73.5 years (range 58-93 years), and people in this age group are prone to falls and fractures [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 64%

“…In a recent paper by Anderson et al [13], there were 36 periprosthetic fractures treated surgically by either ORIF or revision arthroplasty. They concluded that: "Periprosthetic fracture around a humeral stem implant is a difficult clinical problem involving complex decision-making....…”

Section: Discussionmentioning

confidence: 99%

“…Nearly three fourths of all proximal humerus fractures occur in patients older than 60 years, and they generally occur as a result of low-energy trauma such as a fall from standing height [22]. The risk of late periprosthetic fractures is higher due to the presence of the metal implant as stress riser [13,23,24]. While late traumatic (after a fall) periprosthetic humeral fracture in diaphyseal stem prostheses has to be revised in the majority of the cases and has a negative effect on the results [9,13], in our series most of these fractures were metaphyseal and were treated conservatively with excellent outcome.…”

Section: Discussionmentioning

confidence: 99%

“…A significant part of the reported intraoperative, postoperative and difficulty during revision surgery is related to the diaphyseal humeral component [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Reverse shoulder arthroplasty with a short metaphyseal humeral stem

Atoun

Tongel

Hous

et al. 2014

International Orthopaedics (SICOT)

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Purpose Reverse shoulder prostheses have been gaining popularity in recent years. A short metaphyseal stem design will allow bone stock preservation and minimize stem related complications. We examined the clinical and radiographic short-term outcome of a short metaphyseal stem reverse shoulder arthroplasty. Methods Thirty-one patients, with a mean follow-up of 36 months (24-52), were evaluated clinically with the Constant-Murley score, patient satisfaction and pain relief scores. The fixation of the glenoid and humeral components, subsidence and notching were evaluated on radiographs. The indications were cuff tear arthropathy (22), fracture sequelae (five) and rheumatoid arthritis (four). Results The average Constant score improved from 12.7 (range two to 31) pre-operatively to 56.2 (range 17-86) postoperatively. It rose from 13.5 to 58.3 in patients with Cuff arthropathy, from 15.8 to 62.0 in revision arthroplasty, from 10.2 to 47.4 in those with fracture sequelae, and from 11.5 to 55.3 in patients with rheumatoid arthritis. The overall mean patient satisfaction score improved from 2.4/10 to 8.5/10 and mean pain score improved from 0.8/15 to 12.5/15. We found an overall improvement in active forward flexion from 46.8 to 128.5°and from 41.6 to 116.5°in abduction. No humeral loosening or subsidence was observed. Two cases of grade 1-2 glenoid notching were reported. Overall there were three intra-operative fractures that did not affect the operation and healed without affecting the good results. There were five late traumatic periprosthetic fractures, only one of them required a revision surgery to a stemmed implant and the rest healed without surgery. There were two early dislocations that had to be revised. Conclusions The clinical and radiographic evaluation of a bone preserving metaphyseal humeral component in reverse shoulder arthroplasty is promising, with good clinical results, no signs of loosening or subsidence.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…A significant part of the reported intraoperative, postoperative and difficulty during revision surgery is related to the diaphyseal humeral component [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reverse shoulder arthroplasty with a short metaphyseal humeral stem

Atoun

Tongel

Hous

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Complications were frequent, and a reoperation was required in 19 % of the patients. More than half of the patients had a loose humeral component that required revision [ 4 ] …”

Section: T Ype IVmentioning

confidence: 99%