D Adler1, H Siekmann. 1. Universitätsklinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universität Halle, Halle, Deutschland, dan_adl@gmx.de.
Abstract
BACKGROUND: Due to the increasing number of implanted shoulder prostheses following trauma or omarthritis in the recent past, an increase in the occurrence of periprosthetic humeral fractures is to be expected in the future. PROBLEM: For type B fractures according to Worland the current literature clearly recommends operative treatment with fixed angle plate osteosynthesis or a long-stemmed cement-free revision endoprosthesis. This article presents a case study on the clinical and radiological results of a conservatively treated periprosthetic humeral fracture (Wright type B or type B2 according to Worland) and a discussion of the current literature. MATERIAL AND METHODS: A 70-year-old woman was diagnosed with a periprosthetic humeral fracture with an enclosed fracture endoprosthesis (Wright type B). The operative treatment with fixed angle plate osteosynthesis and the alternative conservative therapy with a brace construct were discussed with the patient. The patient decided on the conservative therapy with regular radiological course control. RESULTS: The conservative therapy of periprosthetic type B2 humeral fractures according to Worland using retention in an upper arm brace can lead to excellent radiological and functional results.
BACKGROUND: Due to the increasing number of implanted shoulder prostheses following trauma or omarthritis in the recent past, an increase in the occurrence of periprosthetic humeral fractures is to be expected in the future. PROBLEM: For type B fractures according to Worland the current literature clearly recommends operative treatment with fixed angle plate osteosynthesis or a long-stemmed cement-free revision endoprosthesis. This article presents a case study on the clinical and radiological results of a conservatively treated periprosthetic humeral fracture (Wright type B or type B2 according to Worland) and a discussion of the current literature. MATERIAL AND METHODS: A 70-year-old woman was diagnosed with a periprosthetic humeral fracture with an enclosed fracture endoprosthesis (Wright type B). The operative treatment with fixed angle plate osteosynthesis and the alternative conservative therapy with a brace construct were discussed with the patient. The patient decided on the conservative therapy with regular radiological course control. RESULTS: The conservative therapy of periprosthetic type B2 humeral fractures according to Worland using retention in an upper arm brace can lead to excellent radiological and functional results.
Authors: Sebastian Wutzler; Helmut L Laurer; Stefan Huhnstock; Emanuel V Geiger; Volker Buehren; Ingo Marzi Journal: Arch Orthop Trauma Surg Date: 2008-09-20 Impact factor: 3.067
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