REFERENCES

• 1. Boyd AD Jr, Thornhill TS, Barnes CL. Fractures adjacent to humeral prostheses. J Bone Joint Surg Am, 1992;74:1498-1504.Article
• 2. Chin PY, Sperling JW, Cofield RH, Schleck C. Complications of total shoulder arthroplasty: are they fewer or different? J Shoulder Elbow Surg, 2006;15:19-22.Article
• 3. Groh GI, Heckman MM, Wirth MA, Curtis RJ, Rockwood CA Jr. Treatment of fractures adjacent to humeral prostheses. J Shoulder Elbow Surg, 2008;17:85-89.
• 4. Kang HJ, Lee DY, Sung SY, Hahn SB. Intramedullary nailing for the fracture of proximal humerus. J Korean Fract Soc, 2004;17:271-276.Article
• 5. Kazakos K, Lyras DN, Galanis V, et al. Internal fixation of proximal humerus fractures using the Polarus intramedullary nail. Arch Orthop Trauma Surg, 2007;127:503-508.ArticlePDF
• 6. Kent ME, Sinopidis C, Brown DJ, Frostick SP. The locking compression plate in periprosthetic humeral fractures. A review of two cases. Injury, 2005;36:1241-1245.Article
• 7. Lin J, Hou SM, Hang YS. Locked nailing for displaced surgical neck fractures of the humerus. J Trauma, 1998;45:1051-1057.
• 8. Sarmiento A, Zagorski JB, Zych GA, Latta LL, Capps CA. Functional bracing for the treatment of fractures of the humeral diaphysis. J Bone Joint Surg Am, 2000;82:478-486.Article
• 9. Sarraf KM, Singh R, Corbett SA. Distal humeral plating of an intramedullary nail periprosthetic fracture using a miss-a-nail technique: a case report. Cases J, 2009;2:6704. ArticlePDF
• 10. Seo GY, Ahn JK, Kim YW, Kim JH, Rhee JH. Treatment of humerus shaft fractures using hanging arm cast with plastic cast. J Korean Soc Fract, 1991;4:8-14.Article
• 11. Tsiridis E, Haddad FS, Gie GA. The management of periprosthetic femoral fractures around hip replacements. Injury, 2003;34:95-105.
• 12. Tsiridis E, Spence G, Gamie Z, El Masry MA, Giannoudis PV. Grafting for periprosthetic femoral fractures: strut, impaction or femoral replacement. Injury, 2007;38:688-697.Article
• 13. Worland RL, Kim DY, Arredondo J. Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg, 1999;8:590-594.Article
• 14. Wright TW, Cofield RH. Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am, 1995;77:1340-1346.Article

Fig. 1

Initial radiographs of a 26-year-old woman shows proximal humerus three-part comminuted fracture, involving the metaphysis.

(A) Scapular lateral view.

(B) Humerus antero-posterior view, and (C) Shoulder Axial view.

Fig. 2

Postoperative radiographs show internal fixation of the proximal humerus fracture using the Polarus IM nail (Acumed). The nail head was sunk beneath the humeral head in order to avoid subacromial impingement.

(A) Antero-posterior view, and (B) Lateral view.

Fig. 3

Periprosthetic fracture developed 4 months after the IM nailing. The fracture developed at 2 cm distal to the IM nail tip, spirally advancing distantly toward the metaphysis. Radiographs suggested union of the previously sustained proximal humerus fracture, and stable fixation of the IM nail.

Fig. 4

The IM nail was removed and U-shaped coaptation splint was applied following careful reduction. The previous proximal fracture manifested callus formation and uneventful fracture healing.

Fig. 5

(A) At 12 days after periprosthetic fracture hanging cast is applied.

(B) Initial hanging cast presents posterior angulation and varus angulation of the fracture site.

(C) The strap was lengthened and advanced toward volar aspect of the wrist to correct the posterior angulation and the varus angulation.

Fig. 6

At 3 weeks after periprosthetic fracture functional brace and arm sling were applied.

(A) The fracture angulation and alignment were tolerable.

(B) The elbow motion was gently allowed to prevent stiffness.

Fig. 7

By 40 days after periprosthetic fracture the patient presented ROM recovery both in the (A) shoulder joint, and in the (B) elbow joint.

(C) Radiographs show good alignment and callus formation suggesting successful union process.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by  

• Locking compression plate fixation of periprosthetic distant humeral fracture after intramedullary nail for humeral shaft fracture: A case report
  Mei-Ren Zhang, Kui Zhao, Jiang-Long Guo, Hai-Yun Chen
  Trauma Case Reports.2022; 37: 100565.     CrossRef
• Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture
  Hiren M. Divecha, Hans A. J. Marynissen
  Case Reports in Orthopedics.2013; 2013: 1.     CrossRef