Wright and Cofield classification of postoperative periprosthetic humeral fractures

Last revised by Henry Knipe on 4 Mar 2023

The Wright and Cofield classification system can be used for postoperative periprosthetic humeral fractures. Humeral periprosthetic fractures may be intraoperative or postoperative shoulder arthroplasty complications, which can lead to loosening and migration of the prosthesis 1.


This classification is based on the fracture pattern in relation to the distal tip of the prosthesis 1:

  • type A: centered near the tip and extend proximally

  • type B: centered at the tip with variable extension distally

  • type C: located distal to the tip of the stem

Treatment and prognosis

Treatment involves open reduction-internal fixation (ORIF) or revision shoulder arthroplasty depending on the location of the fracture and stability of the prosthesis. It can be done with plates and screws fixation, plates and cerclage wire, or plates and screws associated with cerclages. Locked screws promote rotational control, and cerclage increases the stability of the construct at the stem level 1.

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