Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 8 , ISSUE 1 ( April, 2013 ) > List of Articles

Original Article

The management of complex periprosthetic humeral fractures: a case series of strut allograft augmentation, and a review of the literature

Alex Trompeter, Rohit R. Gupta

Keywords : Periprosthetic, Fracture, Humerus, Allograft, Strut, Reverse geometry

Citation Information : Trompeter A, Gupta RR. The management of complex periprosthetic humeral fractures: a case series of strut allograft augmentation, and a review of the literature. 2013; 8 (1):43-51.

DOI: 10.1007/s11751-013-0155-x

License: CC BY-NC-SA 4.0

Published Online: 30-04-2013

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

There is little published discussion on the management of postoperative periprosthetic humeral fractures where rotator cuff function is poor, the bone stock is dwindling or both. This is a phenomenon increasingly seen in the older, more osteoporotic population and presents an interesting challenge especially in when faced with these patients with poor bone quality. We present the treatment of three fractures with the use of long-stem reverse geometry arthroplasty and other surgical techniques more commonly reserved for periprosthetic fractures of the proximal femur such as cortical strut allograft augmentation. We believe revision to reverse geometry long-stem implant with cortical strut allograft augmentation to be safe and appropriate in the management of these complex injuries, although technically challenging, and has excellent initial and medium-term results.


PDF Share
  1. Rockwood CA, Green DP, Bucholz RW, Heckman JD, Court- Brown CM (2006) Rockwood and Green's fractures in adults, 6th edn. In: Bucholz RW, Heckman JD, Court-Brown CM (eds); Koval KJ, Tornetta III P, Wirth MA (associate eds). Lippincott Williams & Wilkins, Philadelphia
  2. Steinmann SP, Cheung EV (2008) Treatment of periprosthetic humerus fractures associated with shoulder arthroplasty. J Am Acad Orthop Surg 16(4):199-207
  3. Bohsali KI, Wirth MA, Rockwood CA Jr (2006) Complications of total shoulder arthroplasty. J Bone Joint Surg Am 88(10): 2279-2292. doi:10.2106/JBJS.F.00125
  4. McDonough EB, Crosby LA (2005) Periprosthetic fractures of the humerus. Am J Orthop (Belle Mead NJ) 34(12):586-591
  5. Canale ST, Beaty JH, Campbell WCOo (2008) Campbell's operative orthopaedics, 11th edn. In: Terry Canale S, Beatty JH (eds); editorial assistance by Daugherty K, Jones L; art co-ordination by Burns B. Mosby Elsevier, St. Louis
  6. Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR (1998) Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Shoulder Elbow Surg Am Shoulder Elbow Surg et al. 7(4):406-413
  7. Groh GI, Heckman MM, Wirth MA, Curtis RJ, Rockwood CA Jr (2008) Treatment of fractures adjacent to humeral prostheses. J Shoulder Elbow Surg Am Shoulder Elbow Surg et al. 17(1):85-89. doi:10.1016/j.jse.2007.05.007
  8. Worland RL, Kim DY, Arredondo J (1999) Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg Am Shoulder Elbow Surg et al. 8(6):590-594
  9. Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77(9):1340-1346
  10. 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
  11. Wutzler S, Laurer HL, Huhnstock S, Geiger EV, Buehren V, Marzi I (2009) Periprosthetic humeral fractures after shoulder arthroplasty: operative management and functional outcome. Arch Orthop Trauma Surg Archiv fur orthopadische und Unfall- Chirurgie 129(2):237-243. doi:10.1007/s00402-008-0746-z
  12. Christoforakis JJ, Sadiq S, Evans MJ (2003) Use of a Dall-Miles plate and cables for the fixation of a periprosthetic humeral fracture. Acta Orthop Belg 69(6):562-565
  13. Levy J, Frankle M, Mighell M, Pupello D (2007) The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am 89(2):292-300. doi:10.2106/JBJS.E.01310
  14. Levy JC, Virani N, Pupello D, Frankle M (2007) Use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty in patients with glenohumeral arthritis and rotator cuff deficiency. J Bone Joint Surg Br 89(2):189-195. doi:10.1302/0301-620X.89B2.18161
  15. Frankle M, Levy JC, Pupello D, Siegal S, Saleem A, Mighell M, Vasey M (2006) The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients surgical technique. J Bone Joint Surg Am 88 Suppl 1 Pt 2:178-190. doi: 10.2106/JBJS.F.00123
  16. Sanchez-Sotelo J, O'Driscoll S, Morrey BF (2002) Periprosthetic humeral fractures after total elbow arthroplasty: treatment with implant revision and strut allograft augmentation. J Bone Joint Surg Am 84-A(9):1642-1650
  17. Gohlke F, Rolf O (2007) Revision of failed fracture hemiarthroplasties to reverse total shoulder prosthesis through the transhumeral approach: method incorporating a pectoralis-majorpedicled bone window. Oper Ortho Traumatol 19(2):185-208. doi:10.1007/s00064-007-1202-x
  18. Boyd AD Jr, Thornhill TS, Barnes CL (1992) Fractures adjacent to humeral prostheses. J Bone Joint Surg Am 74(10):1498-1504
  19. Charnley J (1966) The healing of human fractures in contact with self-curing acrylic cement. Clin Orthop Relat Res 47:157-163
  20. Albrektsson T, Johansson C (2001) Osteoinduction, osteoconduction and osseointegration. Eur Spine J 10(Suppl 2):S96-S101. doi:10.1007/s005860100282
  21. De Long WG, Einhorn TA, Koval K, McKee M, Smith W, Sanders R, Watson T (2007) Bone grafts and bone graft substitutes in orthopaedic trauma surgery. A critical analysis. J Bone Joint Surg Am 89(3):649-658. doi:10.2106/JBJS.F.00465
  22. Finkemeier CG (2002) Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am 84-A(3):454-464
  23. Samuels A (2004) Human Tissue Act 2004: the removal and retention of human organs and tissue. Med Leg J 72(Pt 4):148-150
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.