The locking compression plate in periprosthetic humeral fractures A review of two cases.

摘要

Peri prosthetic humeral fractures are becoming increasing common as the prevalence of elbow and shoulder prosthesis increases. It has been reported as many as 5% of primary elbows5 and 0.5-2% of primary shoulder prosthesis will be complicated by a post-operative periprosthetic fracture. There are many references in the literature to periprosthetic fractures around the hip and knee. In compar-. ison very little has been written to guide treatment of periprosthetic humeral fractures around shoulder and elbow prosthesis. It is this lack of experience and the complexity of these fractures which makes them notoriously difficult to treat. Treatment options range from non-operative treatment to internal fixation leaving the prosthesis in situ or full revision of the prosthesis Classification systems to help guide treatment have been described for humeral fractures around shoulder and elbow prosthesis. In 1995 Wright and Colfield16 described a three part classification based on location of the fracture with regafd to the tip of the stem in addition in 1998 Campbell et al. described a four part classificationafter splitting the humerus into four anatomic regions. A classification for fractures around elbow prosthesis has been devised by O'Driscoll et al. in 1999. This is a three part classification depending on anatomic site and the tip of the prosthesis but includes a sub classification relating to bone quality and component fixation.