A simple treatment strategy for peri-implant fracture of the humerus: Report of two cases

• Published in: Journal of Orthopaedic Reports Vol. 2; no. 1; p. 100126
• Main Authors: Subramanyam, Koushik Narayan, Mundargi, Abhishek Vasant, Prabhu, Milind Vittal, Reddy, Devagiri Raviteja
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-01-2023; Elsevier
• Subjects: External fixator; Humerus; JESS; Peri-implant fracture; JESS; Peri-implant fracture; External fixator; Humerus
• ISSN: 2773-157X; 2773-157X
• DOI: 10.1016/j.jorep.2022.100126

Non-prosthetic peri-implant fractures and under reported entities and their optimal management strategies are uncertain.
We present two cases of peri-implant fractures of distal humerus with long dynamic compression plate in situ. We report for the first time a strategy of implant retention, open reduction with small incision, minimal internal fixation with K-wires and supplementary fixation with bilateral external fixator using Joshi's External Stabilizing System (JESS). Both fractures showed signs of union at three months from surgery. The fixators were removed at four months under sedation and patients were advised aggressive active mobilisation of the elbow. This resulted in sound union of the fracture with preservation of elbow motion without any complications.
We recommend this method, as it is a simple, safe, effective and reproducible technique for management of peri-implant fractures of the humerus.