{Reference Type}: Multicenter Study
{Title}: Non-operative management of humeral periprosthetic fracture after stemless shoulder arthroplasty.
{Author}: Dukan R;Juvenspan M;Scheibel M;Moroder P;Teissier P;Werthel JD;
{Journal}: Int Orthop
{Volume}: 48
{Issue}: 1
{Year}: 2024 Jan 20
{Factor}: 3.479
{DOI}: 10.1007/s00264-023-06005-3
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>Conservative management seems to be appropriate in cases of minimally displaced fractures without implant loosening.