Periprosthetic humeral fractures after reverse shoulder arthroplasty. Case report

Wajnsztejn, André; Foni, Noel Oizerovici; Oizerovici, Dan; Pires, Robinson Esteves Santos; Ejnisman, Benno

doi:10.1590/s1679-45082017rc4037

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Since Paul Grammont introduced the modern reverse total shoulder arthroplasty (RSA) design more than 30 years ago, RSA has developed into a mainstay treatment for a variety of shoulder pathologies, including rotator cuff tear arthropathy, massive irreparable rotator cuff tears, complex proximal humerus fractures, and failed shoulder arthroplasty [1][2][3]. RSA is utilized with increasing frequency [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

Brusalis

Taylor

2020

Curr Rev Musculoskelet Med

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Purpose of Review Expanded indications for reverse total shoulder arthroplasty (RSA) have raised awareness of associated complications, including periprosthetic fractures. The purpose of this article was to provide a comprehensive update on how, when, and why RSA-related periprosthetic fractures occur, as well as to describe the current treatment strategies. Recent Findings Periprosthetic acromial and scapular spine fractures occur in up to 4.3% of cases and periprosthetic humeral fractures occur in approximately 3.5% of RSA procedures. Fractures of the coracoid process and clavicle have also been reported. Current literature has identified several risk factors for intraoperative or postoperative fracture, including underlying osteoporosis, revision arthroplasty, use of a superiorly placed screw during metaglene fixation, and disruption of the scapular ring by transection of the coracoacromial ligament. Summary Periprosthetic fracture associated with RSA is a clinically significant event that warrants prolonged postoperative vigilance, timely diagnosis, and shared patient decision-making regarding treatment. Further research is needed to identify optimal treatment strategies and characterize long-term clinical outcomes following RSA-related periprosthetic fracture.

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Section: Introductionmentioning

confidence: 99%

Periprosthetic Fractures in Reverse Total Shoulder Arthroplasty: Current Concepts and Advances in Management

Brusalis

Taylor

2020

Curr Rev Musculoskelet Med

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“…25,42 The mean DASH score was 57.29 (24.1 to 78) (poor). 15,16,28,32 The mean Constant score was 44.75 (25 to 64) (good). 14,22,31 Forward flexion was > 100° or equal to the pre-fracture level in 11 of 13 patients in whom this was reported (from eight stud ies).…”

Section: Revision Arthroplasty Complications Requiring Surgery 11 (14)mentioning

confidence: 98%

Management of periprosthetic fractures of the humerus

Mourkus

Phillips

Rangan

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to investigate the outcome of periprosthetic fractures of the humerus and to assess the uniformity of the classifications used for these fractures (including those around elbow and/or shoulder arthroplasties) by performing a systematic review of the literature. Methods A systematic search was conducted using the National Institute for Health and Care Excellence Healthcare Databases Advance Search. For inclusion, studies had to report clinical outcomes following the management of periprosthetic fractures of the humerus. The protocol was registered on the PROSPERO database. Results Overall, 40 studies were included, involving a total of 210 patients. The fractures were reported using very heterogeneous classification systems, as were the functional outcome scores. A total of 60 patients had nonoperative treatment with a 50% rate of nonunion. Fixation was undertaken in 99 patients; successful union was obtained in 93 (93%). Revision of either the humeral stem or the whole arthroplasty was reported in 79 patients with a high rate of union (n = 66; 84%), and a mean rate of complications of 29% (0% to 41%). Conclusion This study highlighted a lack of uniformity in classifying these fractures and reporting the outcome of their treatment. The results may help to inform decision-making with patients, particularly about the rate of complications of nonoperative treatment. There is a need to improve the reporting of the pattern of these fractures using a uniform classification system, and the harmonization of the collection of data relating to the outcome of treatment. Based on this review, we propose a minimum dataset to be used in future studies. Cite this article: Bone Joint J 2022;104-B(4):416–423.

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