Periprosthetic humeral fractures in patients with total shoulder arthroplasty are rare and difficult to treat. With the significant increase in the number of older patients who have undergone total shoulder arthroplasty in recent years, an increase in the number of periprosthetic shoulder fractures can be estimated. The decisions of treatment have to be taken individually, depending on the stability of the prosthesis, fracture location, and bone quality. On the other hand, there are limited data for treatment guidance and outcomes. This paper reviews the risk factors, classification, treatment, and outcomes of periprosthetic humeral fractures.
Periprosthetic humeral fractures in patients with total shoulder arthroplasty are rare and difficult to treat. With the significant increase in the number of older patients who have undergone total shoulder arthroplasty in recent years, an increase in the number of periprosthetic shoulder fractures can be estimated. The decisions of treatment have to be taken individually, depending on the stability of the prosthesis, fracture location, and bone quality. On the other hand, there are limited data for treatment guidance and outcomes. This paper reviews the risk factors, classification, treatment, and outcomes of periprosthetic humeral fractures.
Fig. 1
Diagram showing the Wright and Cofield classification of a periprosthetic fracture of the humerus. Type A fractures are centered near the tip and extend proximally. Type B fractures are centered at the tip with variable extension distally. Type C fractures are located distal to the tip of the stem.
Fig. 2
Fracture location categories. (A) Region 1, tuberosity fracture. (B) Region 2, metaphyseal portion of the proximal humerus. (C) Region 3, proximal humeral diaphysis. (D) Region 4, mid- and distal humeral diaphysis.
Table 1
Periprosthetic Humeral Fracture
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