Periprosthetic Fractures in Total Elbow Replacement: Classification and Current Treatment Algorithm

Periprosthetic fractures are rare with an estimated prevalence of between 5% and 29%. They can be intraoperative or postoperative and, in cases of the latter, can occur due to either a single traumatic event or secondary to massive loss of bone stock. The Mayo classification distinguishes between three types of fractures: periarticular (a), around the prosthetic stem (b), and distal to the prosthetic stem (c). Among the type B, subtypes 1 through 3 identify the bone stock quality. This classification helps the surgeon decide what type of treatment is most suitable in each case. Some patients can be treated nonoperatively, but most of the fractures usually need fixation, sometimes augmented with bone graft.