A peculiar periprosthetic humeral fracture managed in a simple but effective way

Abstract

{Figure 1} After exposing the fracture posteriorly and securing the radial nerve, the distal fixation was performed first using three 4.5 mm AO cortical screws that were applied in a compression/lag mode to fix the large butterfly to the main distal fragment, converting the fracture to a two-part fracture. {Figure 2} For such a fracture, it was definitely impossible to use any sort of screws around the prosthesis as the stem and cement filled the medullary cavity and the remaining cortex was too thin to provide purchase for any kind of screw. [...]a form of circumferential surface fixation was contemplated.