Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Jan;48(1):253-259.
doi: 10.1007/s00264-023-06005-3. Epub 2023 Oct 20.

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

Ruben Dukan  1 , Marc Juvenspan  2 , Markus Scheibel  3 , Philipp Moroder  3 , Philippe Teissier  4 , Jean David Werthel  5
Affiliations
Multicenter Study

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

Ruben Dukan et al. Int Orthop. 2024 Jan.

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.

Keywords: Arthroplasty; Non-operative management; Reverse shoulder arthroplasty; Shoulder; Stemless.

PubMed Disclaimer

References

    1. Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77:1340–1346. https://doi.org/10.2106/00004623-199509000-00008 - DOI - PubMed
    1. Kirchhoff C, Beirer M, Brunner U et al (2018) Validation of a new classification for periprosthetic shoulder fractures. Int Orthop 42:1371–1377. https://doi.org/10.1007/s00264-018-3774-5 - DOI - PubMed
    1. Habermeyer P, Lichtenberg S, Tauber M, Magosch P (2015) Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg 24:1463–1472. https://doi.org/10.1016/j.jse.2015.02.023 - DOI - PubMed
    1. Fram B, Elder A, Namdari S (2019) Periprosthetic humeral fractures in shoulder arthroplasty. JBJS Rev 7:e6. https://doi.org/10.2106/JBJS.RVW.19.00017 - DOI - PubMed
    1. Lefevre-Colau MM, Babinet A, Fayad F et al (2007) Immediate mobilization compared with conventional immobilization for the impacted nonoperatively treated proximal humeral fracture. A randomized controlled trial. J Bone Joint Surg Am 89:2582–2590. https://doi.org/10.2106/JBJS.F.01419 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources