PubMed · 9769060
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M A Ritter. 1998. Common litigation problems: dueling with the devil.. https://doi.org/10.3928/0147-7447-19980901-44
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The management of humerus fractures is complicated by the presence of a prosthesis. Vigilance in addressing the mechanisms and predisposing factors for periprosthetic fracture may prevent their occurrence. In the event of a periprosthetic fracture, attention to prosthetic stability, fracture location and stability, and bone quality will help guide treatment decisions. Treatment should be commensurate with the goals of fracture stability, early rehabilitation, and maintaining a well-functioning prosthesis.
As total elbow replacements are being performed more frequently, more periprosthetic fractures are occurring. Although this is a frequent topic of discussion for hips and knees, the literature contains little information to guide treatment of such fractures around the elbow. This article outlines the principles of classification and treatment based on the authors' clinical experience with more than 1000 total elbow arthroplasties.
A biomechanical analysis of the trapeziometacarpal joint was performed in 7 fresh-frozen normal human cadaveric hands to compare the kinematics of the trapeziometacarpal joint before and after surface total joint replacement. Using a 3-space magnetic Isotrak system (Polhemus, Colchester, VT), which provides a 3-dimensional analysis of motion of joints as well as translation, we found that kinematics and stability of the trapeziometacarpal joint could be duplicated by joint surface replacement arthroplasty provided that normal ligament tensions were present.