In a review of records and radiographs from 1974 through 1988, we
identified seven patients who had a humeral fracture after either a total
shoulder replacement or a shoulder hemiarthroplasty. All seven patients had
complications after the fracture, and five fractures did not unite until an
operation was done. All of the fractures that were treated operatively
healed without sequelae. Four patients who were managed operatively had
satisfactory relief of pain and one had fair relief. One patient who had a
non-union refused further treatment for medical reasons. The one fracture
that united without operative treatment healed with the tip of the
prosthesis outside of the humeral shaft, but persistent pain led to a
revision total shoulder replacement. The average time to union after the
operation was approximately five months (range, four to seven months).
There was a permanent decrease in the motion of the shoulder from preinjury
levels in five of the six patients who had union of the fracture.