TITLE

Periprosthetic Humeral Fractures During Shoulder Arthroplasty

AUTHOR(S)
Athwal, George S.; Sperling, John W.; Rispoli, Damian M.; Cofield, Robert H.
PUB. DATE
March 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p594
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Currently, there is little information available on the treatment and outcome of intraoperative periprosthetic humeral fractures that occur during shoulder arthroplasty. The purpose of this study was to report on the incidence, treatment, and outcome of, as well as the risk factors for, intraoperative periprosthetic humeral fractures. Methods: Between 1980 and 2002, forty-five intraoperative periprosthetic humeral fractures occurred during shoulder arthroplasty at our institution. Twenty-eight fractures occurred during primary total shoulder arthroplasty, three occurred during primary hemiarthroplasty, and fourteen occurred during revision arthroplasty. Nineteen fractures involved the greater tuberosity, sixteen involved the humeral shaft, six involved the metaphysis, three involved the greater tuberosity and the humeral shaft, and one involved both the greater and lesser tuberosities. All patients were followed for a minimum of two years. At the time of the latest follow-up, outcomes were assessed, radiographs were examined, and relative risks were calculated. Results: Over the twenty-two-year study period, the rate of intraoperative humeral fractures at our institution was 1.5%. All fractures healed at a mean of seventeen weeks. In the primary arthroplasty group (thirty-one patients), range of motion and pain scores improved significantly (p < 0.05) at the time of follow-up. In the revision arthroplasty group (fourteen patients), range of motion remained unchanged whereas pain scores improved significantly (p < 0.005). Transient nerve injuries occurred in six patients. Four fractures displaced postoperatively and were then treated nonoperatively; all four healed. Significant relative risks for intraoperative fracture were female sex, revision surgery, and press-fit implants (p < 0.05). Conclusions: The data from the present study suggest that although intraoperative humeral fractures are associated with a high rate of healing, there was a substantial rate of associated complications, including transient nerve injuries and fracture displacement. Significant risk factors for intraoperative fractures include female sex, revision surgery, and press-fit humeral implants. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
37011892

 

Related Articles

  • Coracoid transfer in Bristow–Latarjet procedure: does it modify the biceps muscle? Castoldi, Filippo; Rossi, Roberto; Lollino, Nicola; Renzulli, Federico; Berrino, Elena; Rossi, Paolo // Knee Surgery, Sports Traumatology, Arthroscopy;Jan2008, Vol. 16 Issue 1, p81 

    The aim of this study is to evaluate the size and morphologic patterns of the biceps muscle after coracoid transfer performed during the Bristow–Latarjet procedure to treat anterior shoulder instability. We analyzed retrospectively 26 patients, who underwent a Bristow–Latarjet...

  • Glenoid Component Failure in Total Shoulder Arthroplasty. Matsen III, Frederick A.; Clinton, Jeremiah; Lynch, Joseph; Bertelsen, Alexander; Richardson, Michael L. // Journal of Bone & Joint Surgery, American Volume;Apr2008, Vol. 90-A Issue 4, p885 

    The article presents a synthesis on the peer-reviewed evidence to clarify the modes of polyethylene glenoid component failure (GCF) in total shoulder arthroplasty, and suggests strategies for addressing each of these modes. Based on the synthesis, it has been observed that GCF occurred when its...

  • RESULTS OF ARTHROSCOPIC TREATMENT OF SUPERIOR LABRAL LESIONS. Seung-Ho Kim; Kwon-Ick Ha; Sang-Hyun Kim; Hee-Joon Choi // Journal of Bone & Joint Surgery, American Volume;Jun2002, Vol. 84-A Issue 6, p981 

    Background: The purpose of this study was to evaluate the results of arthroscopic repair of isolated superior labral lesions of the shoulder. Methods: We evaluated thirty-four patients at a mean of thirty-three months (range, twenty-four to forty-nine months) following arthroscopic repair of an...

  • IATROGENIC SYMPTOMATIC CHEST WALL HEMATOMA AFTER SHOULDER ARTHROPLASTY. Keyurapan, Ekavit; Hu, Samuel J.; Streiff, Michael B.; Fayad, Laura M.; McFarland, Edward G. // Journal of Bone & Joint Surgery, American Volume;Jul2006, Vol. 88-A Issue 7, p1603 

    The article discusses the case of two patients who sustained iatrogenic symptomatic chest wall hematoma after receiving total shoulder arthroplasty. The hemorrhage incidents which developed after surgery stress the risks of perioperative anticoagulation therapy and the diagnostic challenges that...

  • An optimised method for quantifying glenoid orientation. Amadi, Hippolite O.; Banerjee, Sughran; Hansen, Ulrich N.; Wallace, Andrew L.; Bull, Anthony M. J. // International Journal of Shoulder Surgery;Apr2008, Vol. 2 Issue 2, p25 

    A robust quantification method is essential for inter-subject glenoid comparison and planning of total shoulder arthroplasty. This study compared various scapular and glenoid axes with each other in order to optimally define the most appropriate method of quantifying glenoid version and...

  • Defektarthropathie - Langzeitergebnisse der inversen Schultertotalendoprothesenimplantation. Brunner, U.; Rückl, K.; Fruth, M. // Der Orthopäde;Jul2013, Vol. 42 Issue 7, p522 

    The results after reverse total shoulder arthroplasty for cuff tear arthropathy are superior and the complications fewer than for other etiologies, such as rheumatoid arthritis, fracture, fracture sequelae or even revision. The improvements in function and pain are excellent whereas rotation may...

  • Strategien beim Endoprothesenwechsel der Schulter. Habermeyer, P.; Magosch, P. // Der Orthopäde;Jul2013, Vol. 42 Issue 7, p542 

    The increasing number of primary shoulder arthroplasty operations is correlated to an increasing revision rate of up to 11.2 % for anatomical shoulder arthroplasty and 13.4 % for reverse shoulder arthroplasty. To reduce the risk of implant revision the surgeon has to take the possibility of late...

  • Use of the Subscapularis Preserving Technique in Anatomic Total Shoulder Arthroplasty. Simovitch, Ryan; Fullick, Robert; Young Kwon; Zuckerman, Joseph D. // Bulletin of the Hospital for Joint Diseases;2013 Supplement 2, Vol. 71, pS94 

    Subscapularis tenotomy for total shoulder arthroplasty has been the standard approach for shoulder surgeons that utilize the deltopectoral approach. The risk of subscapularis insufficiency after this approach has been well documented. In order to avoid subscapularis complications, Lafosse...

  • Comparison of Outcomes Using Anatomic and Reverse Total Shoulder Arthroplasty. Flurin, Pierre-Henri; Marczuk, Yann; Janout, Martin; Wright, Thomas W.; Zuckerman, Joseph; Roche, Christopher P. // Bulletin of the Hospital for Joint Diseases;2013 Supplement 2, Vol. 71, pS101 

    Worldwide, the usage of both anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) has increased significantly due, in part, to the predictability of acceptable outcomes achieved with each prosthesis type. This study quantifies outcomes using five different...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics