Skip to main content

Periprosthetic Fractures

  • Chapter
  • First Online:
Simple and Complex Fractures of the Humerus

Abstract

The incidence of periprosthetic humeral or scapular fracture associated with shoulder arthroplasty is approximately 0.6–4.5 % of all complications. The full spectrum of periprosthetic fracture at the humerus is well defined by different proposed classification systems. Periprosthetic scapular fractures most commonly occur intraoperatively to the glenoid. Due to the rarity of these fractures, no generally accepted fracture classification exists. Implications of treatment and results are naturally conditioned by the fracture type. For diaphyseal humeral fractures, principles of management are similar for periprosthetic fractures of the hip and long bones. For fractures of the humeral tuberosities, the management is dependent on the fracture shape, and a satisfactory outcome simply requires a nonoperative management with healing of the tuberosity fragment in a minimally displaced position.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gonzalez JF, Alami GB, Baque F, Walch G, Boileau P (2011) Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg 20(4):666–682. doi:10.1016/j.jse.2010.11.017

    Article  PubMed  Google Scholar 

  2. Zumstein MA, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 20(1):146–157. doi:10.1016/j.jse.2010.08.001

    Article  PubMed  Google Scholar 

  3. Boyd AD Jr, Thornhill TS, Barnes CL (1992) Fractures adjacent to humeral prostheses. J Bone Joint Surg Am 74(10):1498–1504

    PubMed  Google Scholar 

  4. Kumar S, Sperling JW, Haidukewych GH, Cofield RH (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 86-A(4):680–689

    PubMed  Google Scholar 

  5. Singh JA, Sperling JW, Cofield RH (2011) Revision surgery following total shoulder arthroplasty: analysis of 2588 shoulders over three decades (1976 to 2008). J Bone Joint Surg Br 93(11):1513–1517. doi:10.1302/0301-620X.93B11.26938

    Article  PubMed  CAS  Google Scholar 

  6. Singh JA, Sperling JW, Cofield RH (2012) Risk factors for revision surgery after humeral head replacement: 1,431 shoulders over 3 decades. J Shoulder Elbow Surg 21(8):1039–1044. doi:10.1016/j.jse.2011.06.015, Epub 2011 Oct 5

    Article  PubMed  PubMed Central  Google Scholar 

  7. Singh JA, Sperling J, Schleck C, Harmsen W, Cofield R (2012) Periprosthetic fractures associated with primary total shoulder arthroplasty and primary humeral head replacement: a thirty-three-year study. J Bone Joint Surg Am 94(19):1777–1785. doi:10.2106/JBJS.J.01945

    Article  PubMed  PubMed Central  Google Scholar 

  8. Steinmann SP, Cheung EV (2008) Treatment of periprosthetic humerus fractures associated with shoulder arthroplasty. J Am Acad Orthop Surg 16(4):199–207

    PubMed  Google Scholar 

  9. Athwal GS, Sperling JW, Rispoli DM, Cofield RH (2009) Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Joint Surg Am 91(3):594–603. doi:10.2106/JBJS.H.00439

    Article  PubMed  Google Scholar 

  10. Chin PY, Sperling JW, Cofield RH, Schleck C (2006) Complications of total shoulder arthroplasty: are they fewer or different? J Shoulder Elbow Surg 15(1):19–22

    Article  PubMed  Google Scholar 

  11. Cameron B, Iannotti JP (1999) Periprosthetic fractures of the humerus and scapula: management and prevention. Orthop Clin North Am 30(2):305–318

    Article  PubMed  CAS  Google Scholar 

  12. Andersen JR, Williams CD, Cain R, Mighell M, Frankle M (2013) Surgically treated humeral shaft fractures following shoulder arthroplasty. J Bone Joint Surg Am 95(1):9–18. doi:10.2106/JBJS.K.00863

    Article  PubMed  Google Scholar 

  13. Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR (1998) Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Shoulder Elbow Surg 7(4):406–413

    Article  PubMed  CAS  Google Scholar 

  14. Groh GI, Heckman MM, Wirth MA, Curtis RJ, Rockwood CA Jr (2008) Treatment of fractures adjacent to humeral prostheses. J Shoulder Elbow Surg 17(1):85–89

    Article  PubMed  Google Scholar 

  15. Bonutti PM, Hawkins RJ (1992) Fracture of the humeral shaft associated with total replacement arthroplasty of the shoulder. A case report. J Bone Joint Surg Am 74(4):617–618

    PubMed  CAS  Google Scholar 

  16. Kligman M, Roffman M (1999) Humeral fracture following shoulder arthroplasty. Orthopedics 22(5):511–513

    PubMed  CAS  Google Scholar 

  17. Williams GR Jr, Iannotti JP (2002) Management of periprosthetic fractures: the shoulder. J Arthroplasty 17(4 Suppl 1):14–16

    Article  PubMed  Google Scholar 

  18. Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77(9):1340–1346

    PubMed  CAS  Google Scholar 

  19. Worland RL, Kim DY, Arredondo J (1999) Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg 8(6):590–594

    Article  PubMed  CAS  Google Scholar 

  20. Rittmeister M, Kersch-Baumer F (2001) Grammont reverse total shoulder arthroplasty in patients with rheumatoid arthritis and non reconstructible rotator cuff lesions. J Shoulder Elbow Surg 10(1):17–22

    Article  PubMed  CAS  Google Scholar 

  21. Crosby L, Hamilton A (2011) Scapula fractures after reverse shoulder arthroplasty: classification and treatment. Clin Orthop Relat Res 469:2544–2549. doi:10.1007/s11999-011-1881-3

  22. Otto RJ, Virani NA, Levy JC, Nigro PT, Cuff DJ, Frankle MA (2013) Scapular fractures after reverse shoulder arthroplasty: evaluation of risk factors and the reliability of a proposed classification. J Shoulder Elbow Surg 22(11):1514–1521. doi:10.1016/j.jse.2013.02.007, pii: S1058-2746(13)00132-8

    Article  PubMed  Google Scholar 

  23. Wahlquist TC, Hunt AF, Braman JP (2011) Acromial base fractures after reverse total shoulder arthroplasty: report of five cases. J Shoulder Elbow Surg 20(7):1178–1183. doi:10.1016/j.jse.2011.01.029

    Article  PubMed  Google Scholar 

  24. Wall B, Nové-Josserand L, O’Connor DP, Edwards TB, Walch G (2007) Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 89(7):1476–1485

    Article  PubMed  Google Scholar 

  25. Molé D, Wein F, Dézaly C, Valenti P, Sirveaux F (2011) Surgical technique: the anterosuperior approach for reverse shoulder arthroplasty. Clin Orthop Relat Res 469(9):2461–2468. doi:10.1007/s11999-011-1861-7

    Article  PubMed  PubMed Central  Google Scholar 

  26. Christofokaris J, Sadio S, Evans M (2003) Use of the Dall-Miles plate and cables for fixation of a periprosthetic humeral fracture. Acta Orthop Belg 69:562–565

    Google Scholar 

  27. De Smet L, Debeer I (2005) Fixation of a Periprosthetic Humeral Fracture with CCG-Cable System. Acta Chir Belg 105:543–544

    PubMed  Google Scholar 

  28. Gerstenfeld LC, Edgar CM, Kakar S, Jacobsen KA, Einhorn TA (2007) Osteogenic growth factors and cytokines and their role in bone repair. In: Bronner F, Farach-Carson MC, Mikos AG (eds) Engineering of functional skeletal tissues topics in bone biology, 3rd edn. Springer, London, pp 17–45. doi:10.1007/978-1-84628-366-6_2

    Chapter  Google Scholar 

  29. Trompeter AJ, Gupta RR (2013) The management of complex periprosthetic humeral fractures: a case series of strut allograft augmentation, and a review of the literature. Strategies Trauma Limb Reconstr 8(1):43–51. doi:10.1007/s11751-013-0155-x

    Article  PubMed  PubMed Central  Google Scholar 

  30. Owens CJ, Sperling JW, Cofield RH (2013) Utility and complications of long-stem humeral components in revision shoulder arthroplasty. J Shoulder Elbow Surg 22(7):e7–e12. doi:10.1016/j.jse.2012.10.034

    Article  PubMed  Google Scholar 

  31. Sommacal R, Bloch HR, Ghidelli A, Bettelli G, Dalla PP (2009) Comminuted periprosthetic humeral fracture after reverse shoulder prosthesis. Chir Organi Mov 93(Suppl 1):S83–S87. doi:10.1007/s12306-009-0013-7

    PubMed  Google Scholar 

  32. Mottier F, Wall B, Nové-Josserand L, Galoisy Guibal L, Walch G (2007) Reverse prosthesis and os acromiale or acromion stress fracture. Rev Chir Orthop Reparatrice Appar Mot 93(2):133–141

    Article  PubMed  CAS  Google Scholar 

  33. Walch G, Mottier F, Wall B, Boileau P, Molé D, Favard L (2009) Acromial insufficiency in reverse shoulder arthroplasties. J Shoulder Elbow Surg 18(3):495–502. doi:10.1016/j.jse.2008.12.002

    Article  PubMed  Google Scholar 

  34. Hamid N, Connor PM, Fleischli JF, D’Alessandro DF (2011) Acromial fracture after reverse shoulder arthroplasty. Am J Orthop (Belle Mead NJ) 40(7):E125–E129

    Google Scholar 

  35. Cheung E, Willis M, Walker M, Clark R, Frankle MA (2011) Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg 19(7):439–449

    PubMed  Google Scholar 

  36. Hattrup SJ (2010) The influence of postoperative acromial and scapular spine fractures on the results of reverse shoulder arthroplasty. Orthopedics 12:33(5). doi:10.3928/01477447-20100329-04

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Celeste Bertone .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Italia

About this chapter

Cite this chapter

Petriccioli, D., Bertone, C., Marchi, G. (2015). Periprosthetic Fractures. In: Castoldi, F., Blonna, D., Assom, M. (eds) Simple and Complex Fractures of the Humerus. Springer, Milano. https://doi.org/10.1007/978-88-470-5307-6_22

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5307-6_22

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5306-9

  • Online ISBN: 978-88-470-5307-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics