This 1995 Mayo Clinic case series examines 9 periprosthetic humeral fractures occurring after 499 shoulder arthroplasties, proposing a three-type classification based on fracture location relative to the prosthesis stem tip and analyzing how fracture type and pattern predict healing with operative vs. non-operative management.
When you see a humeral fracture after shoulder arthroplasty, classify it by stem-tip relationship: Type C fractures distal to the stem behave like standard humeral fractures and can be managed non-operatively if alignment is acceptable, but Type A/B fractures at the stem tip — especially transverse or short oblique patterns.
Warrant early operative intervention with autogenous bone grafting given high nonunion risk. Always assess prosthesis stability, as a loose component with a Type A fracture requires revision to a long-stemmed cemented implant.
This 1995 Mayo Clinic case series examines 9 periprosthetic humeral fractures occurring after 499 shoulder arthroplasties, proposing a three-type classification based on fracture location relative to the prosthesis stem tip and analyzing how fracture type and pattern predict healing with operative vs. non-operative management.
When you see a humeral fracture after shoulder arthroplasty, classify it by stem-tip relationship: Type C fractures distal to the stem behave like standard humeral fractures and can be managed non-operatively if alignment is acceptable, but Type A/B fractures at the stem tip — especially transverse or short oblique patterns.
Warrant early operative intervention with autogenous bone grafting given high nonunion risk. Always assess prosthesis stability, as a loose component with a Type A fracture requires revision to a long-stemmed cemented implant.