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Updated: Jul 24, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Non-operative management of humeral periprosthetic fracture after stemless shoulder arthroplasty
Ruben Dukan1, Marc Juvenspan2, Markus Scheibel3
1APHP, Paris, France, 20 rue leblanc, 75015. ruben.dukan@gmail.com.
Purpose:
Periprosthetic fractures around a stemless implant often involve lesser and greater tuberosities with a well-fixed implant in the metaphysis. This exposes the surgeon to unique questions and challenges as no surgical option (open reduction and internal fixation or revision to a stem) appears satisfactory to address them. Purpose of this study was to evaluate the clinical outcomes after non-operative management of periprosthetic fractures after stemless shoulder arthroplasty.
Methods:
A retrospective multicenter study was conducted to identify all patients who had sustained non-operative management of a periprosthetic fracture after a stemless shoulder. Exclusion criteria were as follows: (1) intraoperative fractures and (2) implant loosening. Primary outcomes included mean Constant score and mean active range of motion. Secondary outcomes were VAS, radiological analysis, and complications.
Results:
Nine patients were included. One was excluded due to the loss of follow-up at three months. Mean age was 79 years. At the last follow-up, no significant difference was observed between the Constant score, VAS, or the range of motion before fracture and at the last follow-up. Fracture healing did not result in any change in angulation in the frontal plane in seven cases and was responsible for a varus malunion in two cases of anatomic arthroplasty. No change in lateralization or distalization was reported. No cases of implant loosening after fracture have been observed.
Conclusions:
Conservative management seems to be appropriate in cases of minimally displaced fractures without implant loosening.
