Single-institution retrospective series from Mayo Clinic examining 16 periprosthetic humeral fractures after shoulder arthroplasty (out of 3091 procedures), describing the Wright-Cofield fracture classification, treatment strategies, and outcomes to develop a management algorithm.
When you see a periprosthetic humeral fracture after shoulder arthroplasty, classify it by the Wright-Cofield system first and assess component fixation: a loose stem mandates long-stem revision regardless of fracture level, while a well-fixed component at the tip (type-B) warrants a 3-month nonoperative trial before committing to ORIF, and fractures distal to the stem (type-C) can be managed like a standard humeral shaft fracture.
Single-institution retrospective series from Mayo Clinic examining 16 periprosthetic humeral fractures after shoulder arthroplasty (out of 3091 procedures), describing the Wright-Cofield fracture classification, treatment strategies, and outcomes to develop a management algorithm.
When you see a periprosthetic humeral fracture after shoulder arthroplasty, classify it by the Wright-Cofield system first and assess component fixation: a loose stem mandates long-stem revision regardless of fracture level, while a well-fixed component at the tip (type-B) warrants a 3-month nonoperative trial before committing to ORIF, and fractures distal to the stem (type-C) can be managed like a standard humeral shaft fracture.