Periprosthetic Fractures of the Shoulder

Abstract

Periprosthetic fractures after shoulder arthroplasty are extremely challenging. Fractures may occur intraoperatively or in the postoperative setting and more commonly involve the humerus but can also affect the glenoid and the scapula. The surgeon will need skills in both fracture fixation and shoulder arthroplasty to manage these injuries. Poor bone quality, bone loss, loose components, and challenging exposure contribute to the difficulties of dealing with these fractures. Treatment options include conservative management using temporary immobilization, or surgical management, which can involve open reduction internal fixation, revision arthroplasty using a long-stem component, or combination of open reduction internal fixation and a long-stem revision implant. As the injuries are rare and highly variable, only level 4 and 5 evidence exists to help guide treatment plans.