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Case Reports
. 2024 May 17;16(5):e60491.
doi: 10.7759/cureus.60491. eCollection 2024 May.

Salvage Treatment for a Periprosthetic Humeral Nonunion: A Case Report

Kassidy Webber  1 , Blake E Delgadillo  1 , Samuel Shepard  2 , Ania Bartholomew  2 , Adam Dann  3
Affiliations
Case Reports

Salvage Treatment for a Periprosthetic Humeral Nonunion: A Case Report

Kassidy Webber et al. Cureus. .

Abstract

The patient, a 69-year-old female, presented one year after receiving a total elbow arthroplasty with a nonunion periprosthetic fracture of the humerus. Due to the patient's severe osteoarthritis of the ipsilateral shoulder and significant humeral deformity, a procedure linking the total elbow arthroplasty to the reverse shoulder implant via a cemented allograft-composite linkage sleeve was performed. Previous literature suggests upper extremity salvage surgery using large-scale allografts is successful in treating large tumor or infection-derived defects, though data is lacking as to whether this treatment is effective in periprosthetic fractures in patients with significant comorbidities. This patient's success in the postoperative year supports the use of allograft-composite reconstruction followed by linkage to a reverse shoulder implant as a salvage treatment for periprosthetic fractures under certain conditions, such as multiple adjacent implants, bone deformity, and severe osteoarthritis.

Keywords: allograft; periprosthetic; periprosthetic fracture; reverse total shoulder; salvage; total humeral replacement.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Preoperative radiograph of periprosthetic humerus fracture.
Arrow designates periprosthetic humerus fracture.
Figure 2
Figure 2. POD0 lateral radiograph of the right humerus with allograft repair and RTSA.
POD: postoperative day; RTSA: reverse total shoulder arthroplasty
Figure 3
Figure 3. POD0 AP radiograph of the right humerus with allograft repair and RTSA.
POD: postoperative day; AP: anteroposterior; RTSA: reverse total shoulder arthroplasty
Figure 4
Figure 4. AP radiograph of the right shoulder at six-month follow-up.
AP: anteroposterior
Figure 5
Figure 5. Lateral radiograph of the right shoulder at six-month follow-up.
Figure 6
Figure 6. External rotation radiograph of the right humerus at six-month follow-up.
Figure 7
Figure 7. AP oblique radiograph of the right shoulder at 12-month follow-up.
AP: anteroposterior
Figure 8
Figure 8. Lateral radiograph of the right shoulder at 12-month follow-up.
Figure 9
Figure 9. External rotation radiograph of the right humerus at 12-month follow-up.
See this image and copyright information in PMC

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