Mennen clamp-on plate fixation of periprosthetic fractures of the humerus after shoulder arthroplasty--a report on 3 patients.

Copyright © Taylor & Francis 2004. ISSN 0001–6470. Printed in Sweden – all rights reserved. DOI 10.1080/00016470410004184 The clamp-on plate described by Mennen (1989) was originally developed only for shaft fractures of the forearm. The therapeutic spectrum has subsequently been expanded to include treatment of periprosthetic fractures of the femur (Liu et al. 1995, Otremski et al. 1998, Kamineni and Ware 1999, Kligman and Roffman 1999). Jähnich et al. (2000) described the use of the Mennen plate for humeral shaft nonunions. Kamineni and Ware (1999) treated 2 periprosthetic humeral head fractures after previous shoulder arthroplasty. We describe our experience of 3 such cases. Case 1 An 81-year-old woman suffered a periprosthetic humeral fracture after a fall, 3 years after a cementless shoulder arthroplasty with a bi-rotational head system for a proximal humerus 4-part fracture (Neer IV). The humeral shaft was unstable and radiographs showed a periprosthetic fracture with a nonunion near the tip of the stem, and cranial migration of the prosthesis in the gleno-humeral joint (Figure 1). We used an anterior approach for fixation with two wire cerclages. For further stabilization, a medium-sized Mennen plate was applied to the humeral shaft. Cancellous bone grafts were applied. At 20 months, radiographs showed a complete bony union and there was no pain (Figure 2). The Constant score was 38 points.