Sultanem Serge, Fares Mohamad Y, Baydoun Hasan
Department of Orthopedics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK.
Clin Shoulder Elb. 2023 Mar;26(1):82-86. doi: 10.5397/cise.2021.00528. Epub 2022 May 2.
Intraoperative periprosthetic humeral fractures are a rare but debilitating complication of reverse shoulder arthroplasty and can occur during multiple stages of the procedure. Prior biceps tenodesis has been found to reduce cortical humeral strength and predispose the patient to humeral fracture. We present a case of a 68-year-old female with a previous history of biceps tenodesis due to an irreparable rotator cuff tear. Months later, and after symptoms persisted, a reverse shoulder arthroplasty was performed. During the surgery and while performing final reduction, a fracture line was observed involving the hole used for the previous tenodesis procedure. The fracture was repaired, and the patient reported favorable outcomes. We report several factors that might have contributed to sustenance of this intraoperative fracture including prior biceps tenodesis, use of a press fit humeral stem, and the sex of the patient.
术中假体周围肱骨骨折是反肩关节置换术一种罕见但会导致功能障碍的并发症，可在手术的多个阶段发生。此前的肱二头肌固定术已被发现会降低肱骨皮质强度，并使患者易发生肱骨骨折。我们报告一例68岁女性病例，该患者既往因不可修复的肩袖撕裂行肱二头肌固定术。数月后，症状持续存在，遂行反肩关节置换术。手术过程中，在进行最终复位时，观察到一条骨折线累及先前固定术所用的孔。骨折得到修复，患者报告预后良好。我们报告了几个可能导致术中骨折发生的因素，包括先前的肱二头肌固定术、使用压配式肱骨干以及患者的性别。
