Treatment of fractures adjacent to humeral prostheses

• Published in: Journal of shoulder and elbow surgery 2008, Vol.17 (1), p.85-89
• Main Authors: Groh, Gordon I., MD, Heckman, Michael M., MD, Wirth, Michael A., MD, Curtis, Ralph J., MD, Rockwood, Charles A., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroplasty, Replacement - adverse effects; Biological and medical sciences; Bone Wires; Female; Fracture Fixation - methods; Humans; Humeral Fractures - classification; Humeral Fractures - etiology; Injuries of the limb. Injuries of the spine; Intraoperative Complications - surgery; Joint Prosthesis; Male; Medical sciences; Middle Aged; Orthopedic surgery; Orthopedics; Prosthesis Failure; Retrospective Studies; Shoulder Joint; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2007.05.007

Fifteen patients with fractures adjacent to a humeral prosthesis were treated between 1986 and 2002. There were 10 females and 5 males. The average age was 58 years. The fractures were classified as to location relative to the prosthesis. Type I fractures (N = 3) occurred proximal to the tip of the prosthesis. Type II fractures (N = 7) occurred in which the fracture line extended from the proximal portion of the humeral shaft to beyond the distal tip of the prosthesis. Type III (N = 5) fractures occurred entirely distal to the tip of the prosthesis. Two type I and 3 type II fractures were managed with a fracture orthosis. The remainder of the fractures were treated surgically with a combination of cerclage wires and long stem prosthesis. All fractures progressed to union at an average of 11 weeks. Average forward elevation for the group was 124°. No patient required a shoulder spica or bone grafting to obtain union. Treatment resulted in fracture union, prosthesis stability, and a paucity of complications.