Abstract：
OBJECTIVE: Periprosthetic fractures around a stemless implant often involve lesser and greater tuberosities with a well-fixed implant in the metaphysis. This exposes the surgeon to unique questions and challenges as no surgical option (open reduction and internal fixation or revision to a stem) appears satisfactory to address them. Purpose of this study was to evaluate the clinical outcomes after non-operative management of periprosthetic fractures after stemless shoulder arthroplasty.
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.
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.
摘要：
目的：无茎植入物周围的假体周围骨折通常涉及较小和较大的结节，植入物固定在干his端。这使外科医生面临独特的问题和挑战，因为没有手术选择（切开复位和内固定或对茎的修正）似乎可以令人满意地解决这些问题。这项研究的目的是评估非手术治疗无柄肩关节置换术后假体周围骨折的临床结果。
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。
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。
