Fractures with osteoporosis

A 48-year-old female was referred to Dr. David L. Helfet 2 days following a fall from a standing height onto her left upper extremity.

Radiographs revealed a periprosthetic fracture above a cemented total elbow replacement and below a cemented humeral component of a total shoulder replacement. Her history was also significant for osteoporosis.

Open reduction and internal fixation (ORIF) was performed with placement of a 3.5mm extra-articular distal humeral locking plate posterior-laterally and a 3.5mm reconstruction plate along the medial column in a 90-90 construct with multiple interfragmentary lag screws.

She returned for routine follow-up and at 7 months radiographs illustrate a healed periprosthetic humerus fracture and she has returned to activities of daily living with resolution of pain.

  • Figure A

    Figure A

    Anteroposterior (AP), oblique and lateral radiographs revealing a periprosthetic humerus fracture between a cemented long stemmed humeral component and a cemented standard length elbow component.

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  • Figure B

    Figure B

    Anteroposterior and lateral fluoroscopic images demonstrating adequate fixation and alignment following open reduction and internal fixation. Radiographs at 7 months postoperatively demonstrate a healed periprosthetic humerus fracture.

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*Carroll EA, Lorich DG, Helfet DL: Surgical management of a periprosthetic fracture between a total elbow and total shoulder prostheses: a case report. J Shoulder Elbow Surg. 2009 18(3):e9-12.

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David L. Helfet, MD

535 East 70th Street
New York, NY 10021

212-606-1888 phone
212-628-4473 fax

New York Fracture Care

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David L. Helfet, MD 
212-606-1888

Dean G. Lorich, MD
212-746-4509

David S. Wellman, MD
212-606-1504