[Periprosthetic humeral fractures: practical guide for treatment : Classification, challenges and contemporary...

Periprosthetic humeral fractures are becoming an increasingly more relevant complication due to the growing number of shoulder arthroplasties being performed. The management of these fractures is complex and influenced by multiple factors.

This article provides a structured overview of current classification systems, discusses therapeutic challenges and outlines contemporary treatment strategies for periprosthetic humeral fractures.

A narrative literature review was conducted focusing on the etiology, classification and treatment options of periprosthetic humeral fractures. Particular attention is given to the classification systems of Wright and Cofield and the classification system of Sanchez-Sotelo PF with an emphasis on their relevance to surgical decision making.

The management of periprosthetic humeral fractures requires an individualized approach. Nondisplaced fractures with a stable implant can be treated conservatively, whereas displaced fractures or those associated with implant loosening typically necessitate surgical intervention. Surgical options include open reduction and internal fixation (ORIF), revision arthroplasty and, in selected cases, the use of custom-made implants. Early mobilization combined with interdisciplinary management is critical to achieving favorable functional outcomes.

Periprosthetic humeral fractures continue to represent a demanding complication in shoulder surgery. A comprehensive understanding of classification systems and modern treatment strategies is essential for accurate treatment planning and improved patient outcomes.