title: Analysis of factors predicting success and failure of treatment after type B periprosthetic humeral fractures: a case series study.
abstract: OBJECTIVE
  The purpose of this study was to investigate which factors predict the failure and success of treatment of periprosthetic type B humeral fractures that have occurred traumatically.
  
  
  METHODS
  The institutional admission database and the trauma registry were retrospectively reviewed. A total of 8 patients suffering from periprosthetic humeral fractures were included. The time span was 10 years (2000-2010).
  
  
  RESULTS
  The average age at the time of the fracture was 77 years. Surgery was performed at an average of 5.6 days after injury. In three patients with a well-fixed and one with an unstable humeral component, open reduction and internal fixation with the use of a plate and screws was performed. Two patients with a Delta prosthesis had an unstable humeral component. A proximal humeral resection and an implantation of an HMRS prosthesis was performed in one patient. The other patient received a Delta revision stem prosthesis, cable and plate fixation. Two patients were treated conservatively.
  
  
  CONCLUSIONS
  Early surgical treatment with angular stable implants in fractures with a stable stem and replacement with a revision long-stem component in fractures with a loose prosthesis is recommended. Special attention should be paid to bone quality and anatomical proximity to the radial nerve. Conservative treatment of type B fractures is not sufficient to achieve union, especially in short oblique or transverse fractures.
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. Harald.Wolf@meduniwien.ac.at.
authors.forename: H
authors.initials: H
authors.lastname: Wolf
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Pajenda
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Sarahrudi
keywords: Nonsurgical treatment; Nonunion; Osteoporosis; Periprosthetic humeral fracture; Surgical treatment
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