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Internal fixation and strut allograft augmentation for periprosthetic humeral fractures
Angel A Martinez1, Angel Calvo, Jorge Cuenca
1Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Medicine School, University of Zaragoza, Zaragoza, Spain. anmarti67@yahoo.es
Purpose:
To report 6 patients with periprosthetic humeral fractures treated with open reduction and internal fixation with plate and strut allograft augmentation.
Methods:
6 women aged 69 to 79 (mean, 73) years underwent open reduction and internal fixation with plate and strut allograft augmentation for periprosthetic humeral fractures (type C) after a fall. They had undergone reverse shoulder arthroplasty for rotator cuff arthropathy. The mean interval between the initial arthroplasty and the fracture was 17 (range, 11-21) months.
Results:
The mean follow-up period was 14 (range, 12-16) months. The mean time to union was 5.4 (range, 4-6) months. All fractures united without complications. The mean Constant score at the last follow-up was 64 (range, 56-80). The range of shoulder movement and patient satisfaction were restored to pre-fracture status in all patients, except for one who had more pain in the lateral area of the arm (probably because of soft-tissue irritation by the plate and wires). Three patients had evidence of graft-to-host union and 3 others had graft resorption.
Conclusion:
Internal fixation with plate, cable wires and strut allogaft augmentation achieves satisfactory results for periprosthetic humeral fractures.
