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International Orthopaedics

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20-10-2023 | Periprosthetic Fracture | Original Paper

Non-operative management of humeral periprosthetic fracture after stemless shoulder arthroplasty

Authors: Ruben Dukan, Marc Juvenspan, Markus Scheibel, Philipp Moroder, Philippe Teissier, Jean David Werthel

Published in: International Orthopaedics | Issue 1/2024

Abstract

Purpose

Periprosthetic fractures around a stemless implant often involve lesser and greater tuberosities with a well-fixed implant in the metaphysis. This exposes the surgeon to unique questions and challenges as no surgical option (open reduction and internal fixation or revision to a stem) appears satisfactory to address them. Purpose of this study was to evaluate the clinical outcomes after non-operative management of periprosthetic fractures after stemless shoulder arthroplasty.

Methods

A retrospective multicenter study was conducted to identify all patients who had sustained non-operative management of a periprosthetic fracture after a stemless shoulder. Exclusion criteria were as follows: (1) intraoperative fractures and (2) implant loosening. Primary outcomes included mean Constant score and mean active range of motion. Secondary outcomes were VAS, radiological analysis, and complications.

Results

Nine patients were included. One was excluded due to the loss of follow-up at three months. Mean age was 79 years. At the last follow-up, no significant difference was observed between the Constant score, VAS, or the range of motion before fracture and at the last follow-up. Fracture healing did not result in any change in angulation in the frontal plane in seven cases and was responsible for a varus malunion in two cases of anatomic arthroplasty. No change in lateralization or distalization was reported. No cases of implant loosening after fracture have been observed.

Conclusions

Conservative management seems to be appropriate in cases of minimally displaced fractures without implant loosening.

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Title: Non-operative management of humeral periprosthetic fracture after stemless shoulder arthroplasty
Authors: Ruben Dukan
Marc Juvenspan
Markus Scheibel
Philipp Moroder
Philippe Teissier
Jean David Werthel
Publication date: 20-10-2023
Publisher: Springer Berlin Heidelberg
Keyword: Periprosthetic Fracture
Published in: International Orthopaedics / Issue 1/2024
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-023-06005-3

2024 ASCO Annual Meeting

Springer Medicine

Non-operative management of humeral periprosthetic fracture after stemless shoulder arthroplasty

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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