Thursday, June 16, 2016

Periprosthetic fracture and management

A patient with primary osteoarthritis

Had a total shoulder arthroplasty 4 years ago

Recently the patient fell, landing on the outstretched arm. At an outside facility, the arm was placed in a plaster splint and x-rays taken with the elbow externally and internally rotated. 

The patient was referred to us for internal fixation.

The splint was removed and the arm was placed in a sling that aligned the fracture well as revealed by two views shown below taken while the arm was in the sling with the forearm across the abdomen.


We anticipate that this fracture will heal without surgery.

Comment: This case points out that the thorax is often the best splint for a midshaft humeral fracture. It also shows that x-ray views of a fractured arm with the distal humerus internally and externally rotated may not be a good idea. 


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