Archives of Orthopaedic and Trauma Surgery

, Volume 129, Issue 2, pp 237–243 | Cite as

Periprosthetic humeral fractures after shoulder arthroplasty: operative management and functional outcome

  • Sebastian WutzlerEmail author
  • Helmut L. Laurer
  • Stefan Huhnstock
  • Emanuel V. Geiger
  • Volker Buehren
  • Ingo Marzi
Trauma Surgery



Currently, little information is available on functional outcome of periprosthetic humeral fractures after shoulder arthroplasty. This investigation aimed to evaluate functional and radiological outcome and patients’ satisfaction following this type of injury treated by open reduction and internal fixation.


Retrospective chart analysis of patients treated at two level-I trauma centers. Patients were examined clinically and radiologically. Additionally, functional outcome was assessed using the established DASH-questionnaire and standardized examination for calculation of the Constant score.


Five out of six patients showed complete fracture consolidation with satisfying functional results (mean follow up time 62 weeks). One patient showed major complications with poor outcome. DASH and Constant scores were comparable to those described after primary shoulder arthroplasty.


Periprosthetic humeral fractures after shoulder arthroplasty can be treated by angular stable plating with low complication rates and acceptable results.


Shoulder arthroplasty Periprosthetic Humeral fracture Complications Classification 


  1. 1.
    Björkenheim JM, Pajarinen J, Savolainen V (2004) Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand 75:741–745. doi: 10.1080/00016470410004120 PubMedCrossRefGoogle Scholar
  2. 2.
    Boyd AD Jr, Thronhill TS, Barnes CL (1992) Fractures adjacent to humeral prosthesis. J Bone Joint Surg Am 74:1498–1504PubMedGoogle Scholar
  3. 3.
    Cameron B, Iannotti JP (1999) Periprosthetic fractures of the humerus and scapula: management and prevention. Orthop Clin North Am 30:305–318. doi: 10.1016/S0030-5898(05)70085-7 PubMedCrossRefGoogle Scholar
  4. 4.
    Campbell J, Moore R, Iannoti J, Norris TR, Williams TR (1998) Periprosthetic humeral fractures: mechanism of fractures and treatment options. J Shoulder Elbow Surg 7(4):406–413. doi: 10.1016/S1058-2746(98)90033-7 PubMedCrossRefGoogle Scholar
  5. 5.
    Chakravarthy J, Bansal R, Cooper J (2007) Locking plate osteosynthesis for Vancouver type B1 and type C periprosthetic fractures of femur: a report on 12 patients. Injury 38:725–733. doi: 10.1016/j.injury.2007.02.038 PubMedCrossRefGoogle Scholar
  6. 6.
    Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMedGoogle Scholar
  7. 7.
    Deshmukh AV, Koris M, Zurakowski D, Thornhill TS (2005) Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg 14(5):471–479. doi: 10.1016/j.jse.2005.02.009 PubMedCrossRefGoogle Scholar
  8. 8.
    Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Am J Ind Med 29:602–608. doi:10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-LPubMedCrossRefGoogle Scholar
  9. 9.
    Kääb MJ, Stöckle U, Schütz M, Stefansky J, Perka C, Haas NP (2006) Stabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases. Arch Orthop Trauma Surg 126:105–110. doi: 10.1007/s00402-005-0075-4 PubMedCrossRefGoogle Scholar
  10. 10.
    Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR (2005) Normalization of the constant score. J Shoulder Elbow Surg 14:278–285. doi: 10.1016/j.jse.2004.10.009 CrossRefGoogle Scholar
  11. 11.
    Kumar S, Sperling JW, Haidukewych GJ, Cofield RH (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg 86(4):680–689PubMedGoogle Scholar
  12. 12.
    Lindahl H, Malchau H, Herberts P, Garellick G (2005) Periprosthetic femoral fractures. J Arthroplasty 20(7):857–865. doi: 10.1016/j.arth.2005.02.001 PubMedCrossRefGoogle Scholar
  13. 13.
    McDonough EB, Crosby LA (2005) Periprosthetic fractures of the humerus. Am J Orthop 34:586–591PubMedGoogle Scholar
  14. 14.
    Parvizi J, Rapuri VR, Purtill JJ, Sharkey PF, Rothman RH, Hozack WJ (2004) Treatment protocol for proximal femoral periprosthetic fractures. J Bone Joint Surg Am 86A(Suppl 2):8–16Google Scholar
  15. 15.
    Robinson CM, Page RS, Hill RMF, Sanders DL, Court-Brown CM, Wakefield AE (2003) Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am 85:1215–1223. doi: 10.1302/0301-620X.85B7.13959 PubMedCrossRefGoogle Scholar
  16. 16.
    Tsiridis E, Spence G, Gamie Z, El Masry MA, Giannoudis PV (2007) Grafting for periprosthetic femoral fractures: strut, impaction or femoral replacement. Injury 38:688–697. doi: 10.1016/j.injury.2007.02.046 PubMedCrossRefGoogle Scholar
  17. 17.
    Worland RL, Kim DY, Arredondo J (1999) Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg 8:590–594. doi: 10.1016/S1058-2746(99)90095-2 PubMedCrossRefGoogle Scholar
  18. 18.
    Wright T, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77:1340–1346PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Sebastian Wutzler
    • 1
    • 3
    Email author
  • Helmut L. Laurer
    • 1
  • Stefan Huhnstock
    • 2
  • Emanuel V. Geiger
    • 1
  • Volker Buehren
    • 2
  • Ingo Marzi
    • 1
  1. 1.Department of Trauma, Hand and Reconstructive SurgeryHospital of the J.W. Goethe-UniversityFrankfurtGermany
  2. 2.Trauma Center MurnauBerufsgenossenschaftliche UnfallklinikMurnauGermany
  3. 3.Klinik für Unfall-, Hand- und WiederherstellungschirurgieZentrum der ChirurgieFrankfurt/MainGermany

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