The Journal of Bone and Joint Surgery, Vol 77, Issue 9 1340-1346, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Humeral fractures after shoulder arthroplasty
TW Wright and RH Cofield
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.
Nine humeral fractures occurred subsequent to 499 shoulder arthroplasties
that had been performed between December 1978 and November 1987 at the Mayo
Clinic. The time from the arthroplasty to the fracture averaged thirty-nine
months (range, eight to 101 months). Seven patients were women and two were
men, and the average age was seventy years (range, forty-five to
eighty-five years). The arthroplasties were performed for rheumatoid
arthritis in five patients and for the sequelae of trauma in four. Six
patients had advanced osteopenia, and two had had an ipsilateral total
elbow arthroplasty. Six of the fractures were centered at the tip of the
prosthesis; one fracture (type A) extended proximally, and five (type B)
did not. The three remaining fractures (type C) involved the humeral shaft
distal to the implant and extended into the distal humeral metaphysis. Four
fractures healed with non-operative treatment. Two fractures that had
unacceptable alignment were treated successfully with operative
intervention. Three fractures that were treated with immobilization in a
splint failed to heal; two of those fractures eventually united after a
revision of the prosthesis and bone-grafting was performed, and one
fracture remained ununited. Radial nerve palsy developed postoperatively in
two patients, and it resolved within three months. Five patients had poor
active motion before the fracture, and two of them had even less motion
after the fracture was treated. Our experience suggests that long oblique
and spiral fractures can be successfully treated non-operatively, provided
that the skeletal alignment is acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
