Presentation
Left-handed, fell to the ground 10 years after reverse total shoulder arthroplasty for left shoulder cuff tear arthropathy.
Patient Data
Periprosthetic fracture distal to the tip of the humeral stem. The stem is stable.
Fracture reduction and fixation with locking plate and screws.
Case Discussion
The Wright and Cofield classification system can be used for postoperative periprosthetic humerus fractures and is based on the fracture pattern in relation to the distal tip of the prosthesis:
- type A fractures are centered near the tip and extend proximally
- type B fractures are centered at the tip with variable extension distally
- type C fractures are located distal to the tip of the stem
Fixation can be done with plates and screws, plates and cerclages, and plates and screws associated with cerclages. Locked screws promote rotational control, and cerclage increases the stability of the construct at the stem level.
Radiographer: TSRM Fabio Imola
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