ArticleArchives of orthopaedic and trauma surgery2023
Inadvertent, intraoperative, non- to minimally displaced periprosthetic humeral shaft fractures in RTSA do not affect the clinical and radiographic short-term outcome.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Clinical outcomes of cemented vs. uncemented reverse total shoulder arthroplasty for proximal humerus fractures: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Use of a Low Profile Ultra-High Molecular Weight Polyethylene Diaphyseal Humeral Cement Restrictor in Shoulder Arthroplasty.Journal of shoulder and elbow arthroplasty · 2024Article
- Periprosthetic fractures after shoulder arthroplasty: a systematic review.EFORT open reviews · 2023Article
- Greater Tuberosity Fractures after RTSA: A Matched Group Analysis.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLittle information is available on the clinical and radiographic outcome of intraoperative, non- to minimally displaced humeral fractures that occur during implantation of a stemmed, reverse shoulder prosthesis but are only recognized on routine postoperative radiographs. The goal of this study is to report the clinical and radiographic outcome for this rarely reported fracture type. MATERIALS AND
methods39 conservatively treated non- to minimally displaced intraoperative periprosthetic humeral fractures after stemmed RTSA were detected from our radiographic database between 1.1.2006 and 31.1.2018. Exclusion criteria were lack of patient consent, preoperative humeral fracture, and revision arthroplasties. Clinical (absolute and relative Constant score, the Subjective Shoulder Value) and radiographic (conventional radiographs) assessment was performed preoperatively, at 6 weeks (only radiographically) and at latest follow-up with a minimum follow-up of 2 years.
results35 patient's with a mean age of 72 years (range 32-88, SD ± 11 years) and a mean follow-up of 53 months (range 24-124, SD ± 31) were included in the study. At latest follow-up, all clinical outcome parameters except external rotation improved significantly. A complication rate of 17% (n:6) was recorded. At 6 weeks after the index surgery, none of the radiographs showed a fracture displacement or a sintering of the stem. At latest follow-up, all fractures were healed and no stem loosening was observed in any of the shoulders.
conclusionsNon- to minimally displaced intraoperative periprosthetic humeral fractures in RTSA have an incidence of about 5% in this series of mainly uncemented press-fit stems. They generally heal without any further treatment and are not associated with stem loosening or compromise the clinical outcome after primary RTSA. Except slight restriction in the postoperative rehabilitation protocol, no further attention or action is needed.
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