title: Periprosthetic humeral fractures associated with reverse total shoulder arthroplasty: incidence and management.
abstract: OBJECTIVE
  The purpose of this study was to record the incidence and management of periprosthetic humeral fractures (PHF) using reverse total shoulder arthroplasty (RTSA) in our institution.
  
  
  METHODS
  We performed a retrospective study of 203 RTSA implanted in 200 patients between 2003 and 2014. The mean follow-up was 78.82 months (range, 12-141). Mean age of the study cohort was 75.87 years (range, 44-88). There were only 25 male patients (12.5 %). We assessed the presence of periprosthetic humeral fractures studying the medical files and X-rays of all patients.
  
  
  RESULTS
  We identified seven periprosthetic humeral fractures in 203 RTSA (3.4 %): three intra-operative (1.47 %) and four post-operative (1.97 %). The average age at the time of the fracture was 75.14 years (59-83). All patients were women (100 %). Three patients with post-operative fractures type B were treated by osteosynthesis, and one patient with post-operative fracture type A was treated conservatively. All intra-operative fractures needed cerclage wire and in one case long cemented stem. All our periprosthetic fractures healed.
  
  
  CONCLUSIONS
  Surgical treatment with osteosynthesis in type B post-operative fractures with a stable stem is recommended. Conservative treatment is sufficient in non-displaced type A post-operative fracture. Special attention should be paid to bone quality patients using non-cemented stems in primary surgery but especially in revision shoulder surgery.
authors: Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain. carlosgf1969@gmail.com.
authors: Carlos
authors: C
authors: García-Fernández
authors: Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain.
authors: Yaiza
authors: Y
authors: Lópiz-Morales
authors: Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain.
authors: Alberto
authors: A
authors: Rodríguez
authors: Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain.
authors: Luis
authors: L
authors: López-Durán
authors: Department of Orthopaedics, Hospital Clínico San Carlos, Madrid, Spain.
authors: Fernando Marco
authors: FM
authors: Martínez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D015994:Incidence; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*
keywords: Complications reverse shoulder arthroplasty; Periprosthetic humeral fractures