Small Fragment Instrumentation for Periprosthetic Humerus Fracture Fixation Technique

Periprosthetic humerus fractures remain problematic complications that are difficult to adequately reduce and maintain reduction. Patient-related risk factors, including poor bone quality, add an additional level of complexity to maintaining fixation in the setting of relatively narrow cortical margins adjacent to the shoulder prosthesis. Based on the challenges of obtaining adequate proximal fixation and the need to minimize dependence on cerclage fixation because of nerve injury risks and inadequate fracture reduction, the authors propose an alternative method intraoperative fixation. The technique described is a method of fixation utilizing a small fragment instrumentation set for periprosthetic humerus fractures as demonstrated in a Sawbones model and intraoperatively in a patient-specific case.