Fractures

Periprosthetic humeral fractures after shoulder arthroplasty are rare, with prevalence reported between 1.6% and 2.4%.13, 14

Fractures are classified on the basis of their location with respect to the distal tip of the humeral implant, according to the system of Wright and Cofield.15 Type-A fractures occur at the tip of the prosthesis and extend proximally. Type B fractures occur at the tup of the prosthesis without extension or with only minimal extension proximally but can have a variable amount of extension distally. Type C fractures are located distal to the tip of the prosthesis.

Location and configuration of the fracture has an important effect on outcome.

Type C fractures are similar to closed fractures of the humeral shaft and respond favorably to nonoperative treatment.

However, fractures that are at the tip of the prosthesis (type A and B fractures) behave differently. They frequently require operative intervention, especially if the prosthesis is loose.16

Type C periprosthetic humerus fracture managed conservatively with sling, demonstrating anatomic healing.

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