Periprosthetic proximal humerus fractures require an individualized treatment approach—results of a multicenter retrospective study.
Background: In the last years, there has been increasing use of shoulder arthroplasty. As a result, an increasing incidence of periprosthetic humerus fractures (PPHF) is expected. Therefore, this retrospective, multicenter analysis aimed to collect demographic data from patients with PPHF, their tre...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 50; no. 4; pp. 1921 - 1929 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2024
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180130961&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180130961 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Aug2024 vid: 50 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 180130961 177507509 180130961 180130961 10.1007/s00068-024-02553-4 180130961 ppf: 1921 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Periprosthetic proximal humerus fractures require an individualized treatment approach—results of a multicenter retrospective study. aug: au: Boesmueller, Sandra Lorenz, Greta Kinsky, Rudolf Maximilian Schallmayer, Daniel Fialka, Christian Mittermayr, Rainer affil: AUVA Trauma Center Vienna Meidling, Kundratstrasse 37, 1120, Vienna, Austria sug: subj: Periprosthetic Fractures Epidemiology Humeral Fractures Epidemiology Individualized Medicine Periprosthetic Fractures Surgery Humeral Fractures Surgery Fracture Fixation Methods Postoperative Complications Treatment Outcomes Human Male Female Aged Aged, 80 and Over Retrospective Design Record Review Multicenter Studies Humeral Fractures Classification Accidental Falls Arthroplasty, Reverse Total, Shoulder Adverse Effects Hemiarthroplasty Comorbidity Open Reduction Internal Fixation Reoperation Peripheral Nervous System Diseases Risk Factors Fractures, Ununited Risk Factors Aged: 65+ years Aged, 80 & over Male Female ab: Background: In the last years, there has been increasing use of shoulder arthroplasty. As a result, an increasing incidence of periprosthetic humerus fractures (PPHF) is expected. Therefore, this retrospective, multicenter analysis aimed to collect demographic data from patients with PPHF, their treatment strategies, and associated complications. Methods: Demographics of patients with PPHF were collected retrospectively from the database of six trauma hospitals between January 2000 and December 2020. All fractures were categorized according to the Wright and Cofield, and Worland classifications. In addition, the type of treatment for PPHF, as well as subsequent complications, were evaluated. Results: A total of 72 patients with a PPHF were identified. The mean age of the 55 female and 17 male patients was 77 years. PPHF occurred a mean of 50 months after primary arthroplasty implantation, almost exclusively as a result of a fall from standing height (n = 67). In-situ implant was a RTSA in 40 patients and a hemiarthroplasty in 32 patients. More than half of the fractures (n = 38) were type B fractures, according to Wright and Cofield. According to Worland, the majority of patients also had a type B fracture (type B1 (n = 22), type B2 (n = 28), type B3 (n = 10)). Associated comorbidities were found in 21 patients. A total of 31 patients were treated non-operatively, 27 with Open Reduction Internal Fixation (ORIF), and 14 with a revision arthroplasty. Nine primary radial nerve palsies were found (pre-operatively), and seven secondarily (post-operatively). Nine patients suffered from non-union (ORIF 4, non operative 4, stem replacement 1). Conclusion: The treatment strategy for PPHF is primarily tailored to the individual patient. Decisive factors such as patient's age, fracture type, and primary palsies have to be considered for optimal treatment. In type B1 fractures, there is a recommendation for ORIF because of high non-union rates under non-operative treatment. In contrast, in type B2 fractures, a non-operative approach should be preferred, provided there are no radial nerve lesions. Level of evidence: Level IV, epidemiologic study. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|