Orthopedics. 2020 Nov 1;43(6):e553-e560. doi: 10.3928/01477447-20200910-06. Epub 2020 Sep 22.
Few studies report on periprosthetic humeral shaft fractures after reverse total shoulder arthroplasty (RTSA). The authors evaluated outcomes of 5 patients with this complication who were initially treated nonoperatively. Of 152 patients who underwent RTSA at the authors' institution from 2012 to 2017, 4 experienced periprosthetic humeral shaft fractures. One patient was referred to the authors for fracture treatment. All 5 patients were initially treated nonoperatively. The mean duration of follow-up was 11.5 months (range, 1.5-26 months). The authors analyzed time to fracture union, Single Assessment Numeric Evaluation (SANE) score, visual analog scale (VAS) score for pain, and active shoulder range of motion. Fracture union occurred in 4 patients treated nonoperatively at a mean of 4.4 months. Mean SANE score was 55 of 100 (range, 20-85). Mean VAS score was 3.4 of 10 (range, 0-8). Mean forward elevation was 83° (range, 45°-110°); mean abduction was 65° (range, 45°-80°); and mean external rotation with the arm at the side was 15° (range, 0°-30°). Many factors must be considered when customizing treatment for patients with periprosthetic fracture after RTSA. This case series indicates that nonoperative treatment of postoperative periprosthetic humeral shaft fractures can be successful. [Orthopedics. 2020;43(6):e553-e560.].
很少有研究报道反式全肩关节置换术（RTSA）后假体周围肱骨干骨折。作者评估了 5 例此类并发症患者的治疗结果，这些患者最初接受了非手术治疗。在作者所在机构，2012 年至 2017 年期间，共有 152 例患者接受了 RTSA，其中 4 例发生假体周围肱骨干骨折。1 例患者因骨折来作者处治疗。所有 5 例患者最初均接受非手术治疗。平均随访时间为 11.5 个月（范围，1.5-26 个月）。作者分析了骨折愈合时间、单一评估数字评估（SANE）评分、疼痛视觉模拟评分（VAS）和主动肩关节活动范围。4 例非手术治疗的患者平均 4.4 个月骨折愈合。平均 SANE 评分为 55 分（范围，20-85）。平均 VAS 评分为 3.4 分（范围，0-8）。平均前向抬高 83°（范围，45°-110°）；平均外展 65°（范围，45°-80°）；手臂在体侧时的外旋平均为 15°（范围，0°-30°）。在为 RTSA 后假体周围骨折患者定制治疗方案时，必须考虑许多因素。本病例系列表明，术后假体周围肱骨干骨折的非手术治疗可能是成功的。[骨科。2020;43(6):e553-e560.]。
