Open Reduction and Internal Fixation of a Diaphyseal Periprosthetic Humeral Fracture

1. Introduction

2. Exposure

1. Posterior Skin Incision
2. Dissection Lateral to Triceps Muscle
3. Identify Proximal and Distal Fragments
4. Debride Fracture

3. Reduction

1. Clamp Humerus Out to Length
2. X-Ray Confirmation
3. Dissect Triceps from Distal Fragment
4. Select Plate

4. Lag Screws

1. Drill Across Fracture
2. Countersink
3. Measure for Screw Length
4. Insert Screw
5. Repeat for 2nd Screw

5. Plate Fixation

1. Position Plate
2. X-Ray Confirmation
3. Contour Plate
4. Provisional K-Wire Fixation
5. Drill, Measure, and Insert Screws
6. Final X-Rays and Radial Nerve Review

6. Closure

7. Post-op Remarks