COPYRIGHT © 2002 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED Periprosthetic Humeral Fractures After Total Elbow Arthroplasty: Treatment with Implant Revision and Strut Allograft Augmentation

Background: Periprosthetic fractures are among the most challenging complications of elbow arthroplasty, and published information about the outcome of treatment is limited. The purpose of the present study was to de-termine the results of implant revision and strut allograft augmentation for the treatment of humeral peripros-thetic fractures that occur around a loose humeral component. Methods: Between 1991 and 1999, eleven periprosthetic fractures that occurred around a loose humeral com-ponent were treated with cortical strut allograft augmentation and revision arthroplasty with use of a Coonrad-Morrey semiconstrained implant. Six fractures occurred after a primary arthroplasty, and five occurred after a revision arthroplasty. Two parallel strut grafts were used for fracture fixation in most cases. Patients were fol-lowed for an average of three years (range, nine months to 7.8 years) and were evaluated clinically and radio-graphically. Results: Clinical and radiographic fracture union was obtained in ten of the eleven patients. One patient re-quired revision surgery because of aseptic loosening of the humeral component seven years and nine months after fracture union; there were no other implant failures. Complications included one additional nondisplaced humeral periprosthetic fracture after surgery that failed to heal with closed treatment, one olecranon fracture, one permanent ulnar nerve injury, and one case of triceps insufficiency. At the time of the most recent follow