METHODS: A retrospective multicenter study was conducted to identify all patients who had sustained non-operative management of a periprosthetic fracture after a stemless shoulder. Exclusion criteria were as follows: (1) intraoperative fractures and (2) implant loosening. Primary outcomes included mean Constant score and mean active range of motion. Secondary outcomes were VAS, radiological analysis, and complications.
RESULTS: Nine patients were included. One was excluded due to the loss of follow-up at three months. Mean age was 79 years. At the last follow-up, no significant difference was observed between the Constant score, VAS, or the range of motion before fracture and at the last follow-up. Fracture healing did not result in any change in angulation in the frontal plane in seven cases and was responsible for a varus malunion in two cases of anatomic arthroplasty. No change in lateralization or distalization was reported. No cases of implant loosening after fracture have been observed.
CONCLUSIONS: Conservative management seems to be appropriate in cases of minimally displaced fractures without implant loosening.
方法:进行了一项回顾性多中心研究,以确定所有在无柄肩关节后持续非手术治疗假体周围骨折的患者。排除标准如下:(1)术中骨折和(2)植入物松动。主要结果包括平均Constant评分和平均活动范围。次要结果是VAS,放射学分析,和并发症。
结果:纳入9例患者。由于在三个月时失去随访,一个被排除在外。平均年龄79岁。在最后一次随访中,Constant评分之间没有观察到显著差异,VAS,或骨折前和最后一次随访时的活动范围。在7例病例中,骨折愈合并未导致额平面角度的任何变化,而在2例解剖关节成形术中,骨折愈合是造成内翻畸形的原因。没有报告侧向化或远端化的变化。没有观察到骨折后植入物松动的病例。
结论:保守治疗似乎适用于无植入物松动的最小移位骨折病例。