Authors of section

Authors

Samy Bouaicha, Stefaan Nijs, Markus Scheibel, David Weatherby

Executive Editor

Simon Lambert

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Humeral implant stable, good bone

General considerations

The humeral component remains securely fixed, and the shoulder joint is usually stable. The principles of fracture treatment are similar to those used for metaphyseal and diaphyseal humeral fractures without a shoulder replacement in situ.

Per 10 D220 Definition

Etiology

The humeral shaft fracture occurs as a result of:

  • Twisting, eg, applying excessive torsional force during intraoperative location of a total shoulder replacement, or as a result of a standing height fall
  • Bending, eg, as a result of a standing height fall
  • Osteopenia
  • Impaction, eg, excessive axial force during medullary preparation for humeral component implantation
  • Distraction, eg, excessive axial force during explantation of a well-fixed humeral component in weak bone

Clinical signs

  • Pain
  • Swelling and bruising
  • Restricted active movement
  • Tenderness
  • Associated nerve and vessel injuries

Imaging

Plain x-rays, including orthogonal AP and lateral views will show the fracture. CT may be indicated to assess the medullary dimension for revision implantation and fracture management.

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