Treatment of Upper Extremity Periprosthetic fracture - tips and tricks for the trauma surgeon

Thursday, October 19, 2023

2:00 PM – 3:00 PM PST

Location: 606-607

Moderator(s)

Niloofar Dehghan, MD

Chief of trauma; Associate professor
The CORE Institute; University of Arizona College of Medicine Phoenix
Phoenix, Arizona, United States

Disclosure(s): acumed: Consultant (Ongoing); ITS: Consultant (Ongoing); stryker: Consultant (Ongoing)

Faculty(s)

Kenneth A. Egol, MD

NYU Langone Orthopedic Hospital
New York, New York, United States

Disclosure(s): No financial relationships to disclose
Niloofar Dehghan, MD

Chief of trauma; Associate professor
The CORE Institute; University of Arizona College of Medicine Phoenix
Phoenix, Arizona, United States

Disclosure(s): acumed: Consultant (Ongoing); ITS: Consultant (Ongoing); stryker: Consultant (Ongoing)
Michael McKee, MD

Professor and Chairman
University of Arizona College of Medicine-Phoenix
Phoenix, Arizona, United States

Disclosure(s): Exactech: Consultant (Ongoing); ITS: Consultant (Ongoing); LWW: Other Financial or Material Support (Ongoing); Stryker: Consultant (Ongoing); Wolters Kluwer: Other Financial or Material Support (Ongoing)
BO

Ben Ollivere, MD

Chair of Orthopaedic Trauma
Univeristy of Nottingham
Nottingham, England, United Kingdom

Disclosure(s): Smith & Nephew: Consultant (Ongoing), Grant or Research Support, or I am listed as the PI (Ongoing), Other Financial or Material Support (Ongoing); Stryker: Consultant (Ongoing), Speakers Bureau (Ongoing)

The prevalence of upper extremity periprosthetic fracture is increasing significantly. While trauma surgeons are well trained and comfortable with treatment of lower extremity periprosthetic fractures, for some, fractures of the upper extremity remain elusive. We believe a trauma surgeon should have the appropriate knowledge and expertise to treat fractures of the upper extremity, such as periprosthetic fractures around a shoulder or elbow prosthesis, or acromion stress fractures associated with reverse shoulder arthroplasty.

While there is a lot of emphasis on lower extremity periprosthetic fractures at trauma meetings and the OTA, educational sessions on upper extremity periprosthetic fractures have been deficient. We believe this is an area of trauma that trauma surgeons should be able to manage, and not defer to the "shoulder" surgeons. We believe the lack of educational sessions may be the reason why some trauma surgeons are not comfortable with managing these injuries, and their opportunity to improve this knowledge gap.

This breakout session discusses how to best treat these difficult injuries for optimal outcomes: when is non-operative treatment is appropriate, which should be treated surgically, as well as technical aspects of how to perform the surgical procedures.

Learning Objectives:

At the completion of this activity, participants will be able to:

Identify when non-operative treatment is appropriate, and when is surgery indicated. Which fractures should a trauma surgeon be able to manage, and which need revision arthroplasty.
Appraise humeral shaft periprosthetic fractures - technical aspects of surgical fixation to obtain the best outcomes.
Understanding scapula and acromion fractures in the setting of reverse shoulder arthroplasty - They need surgery, but how to achieve union.