Analysis of factors predicting success and failure of treatment after type B periprosthetic humeral fractures: a case series study

作者：Wolf H^*; Pajenda G; Sarahrudi K

来源：European Journal of Trauma and Emergency Surgery, 2012, 38(2): 177-183.

DOI：10.1007/s00068-011-0145-y

• Periprosthetic humeral fracture
• Nonunion
• Surgical treatment
• Nonsurgical treatment
• Osteoporosis

Purpose The purpose of this study was to investigate which factors predict the failure and success of treatment of periprosthetic type B humeral fractures that have occurred traumatically. %26lt;br%26gt;Methods The institutional admission database and the trauma registry were retrospectively reviewed. A total of 8 patients suffering from periprosthetic humeral fractures were included. The time span was 10 years (2000-2010). %26lt;br%26gt;Results The average age at the time of the fracture was 77 years. Surgery was performed at an average of 5.6 days after injury. In three patients with a well-fixed and one with an unstable humeral component, open reduction and internal fixation with the use of a plate and screws was performed. Two patients with a Delta prosthesis had an unstable humeral component. A proximal humeral resection and an implantation of an HMRS prosthesis was performed in one patient. The other patient received a Delta revision stem prosthesis, cable and plate fixation. Two patients were treated conservatively. %26lt;br%26gt;Conclusions Early surgical treatment with angular stable implants in fractures with a stable stem and replacement with a revision long-stem component in fractures with a loose prosthesis is recommended. Special attention should be paid to bone quality and anatomical proximity to the radial nerve. Conservative treatment of type B fractures is not sufficient to achieve union, especially in short oblique or transverse fractures.

• 出版日期2012-4