Intraoperative Fracture in Reverse Shoulder Arthroplasty
With the increase in reverse shoulder arthroplasty (RSA) rates, the number of perioperative complications, such as periprosthetic fractures, continues to rise. Even if humeral and glenoid fractures are the most frequently observed, further fractures, as acromion or coracoid fracture, can occur. The majority of intraoperative humeral fractures is observed during implantation in primary arthroplasty and, much more frequently, during removal of the primary humeral stem or cement mantle in revision surgery. Whereas, intraoperative glenoid fractures are related to the initial reaming or fixation technique. The treatment depends on the location of the fracture in respect to the prosthetic component and the stability of the component/bone interface. In most cases humeral fractures are nondisplaced or minimally displaced, and the fixation of the stem or cerclage wire allows to achieve a good stability of the implant and the consolidation of the fracture. Glenoid fractures are frequently partial and can be reduced and fixed using the glenoid baseplate and screws of the glenoid component. Although intraoperative fracture in RSA is associated with a high rate of bone healing, there is a substantial rate of associated complications and lower functional result. In order to prevent perioperative fractures, attention has to be paid to bone quality in primary but especially in revision shoulder surgery.
KeywordsPeriprosthetic fracture Glenoid Humerus Reverse prosthesis Complication
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