Wednesday, September 21, 2016

Humeral shaft fracture after total shoulder arthroplasty

These are the x-rays of a right shoulder three years after a total shoulder arthroplasty. The shoulder was comfortable and fully functional.
Soon after the above films were obtained, the patient sustained a 6 foot fall landing with the mid humerus on the edge of a sharp rock. We were sent these x-rays:

The transverse midshaft humeral fracture is seen (a 'night stick' type of fracture). It is apparent that the splint was not controlling rotation.

We removed the arm from the splint and placed the arm in an ordinary sling. Three months later the fracture was healed clinically and radiographically and the shoulder essentially back to its pre fracture status.

Comment: While some had advised revision to a long stem prosthesis, in this case simple non-surgical management was effective.

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