Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Hughston Clinic, Columbus, Georgia.
JBJS Case Connect. 2021 Apr 7;11(2):01709767-202106000-00008. doi: e20.00665.
We present a case of a physical therapy-induced fracture of the proximal humerus, presumably caused by forceful shoulder flexion and external rotation, after reverse total shoulder arthroplasty (RTSA) in a 70-year-old woman with underlying osteopenia, systemic lupus erythematosus, long-term glucocorticoid use, and common variable immunodeficiency.
This case of a physical therapy-induced greater tuberosity fracture after RTSA presents an example of an early postoperative complication with no impact on eventual successful surgical outcomes. Special consideration should be given to tailor the postoperative rehabilitation after RTSA in patients with increased risk of fractures.
我们报告了一例 70 岁女性在反向全肩关节置换术后（RTSA）发生的肱骨近端物理治疗引起的骨折，该患者存在骨质疏松症、系统性红斑狼疮、长期使用糖皮质激素和常见可变免疫缺陷等潜在疾病，推测是由于剧烈的肩部前屈和外旋导致的。
本病例为 RTSA 后物理治疗引起的大结节骨折，是一种早期术后并发症的例子，对最终成功的手术结果没有影响。对于有骨折风险增加的患者，应特别考虑调整 RTSA 后的术后康复方案。
