Surgical technique

Advantages

Disadvantages

Replace stem with one that bridges fracture

Stability of fracture site

Non-systematic approach to

fracture site

Joint approach

Increased risk of infection

Stiffness

Loss of bone stock Risk of glenohumeral instability

Fixation with plate and wire cerclage

Existing implants preserved

No joint approach

Wire cerclage and stem stability not always optimal Fragile bone (like a hot knife through butter)

Theoretical neurological risk due to wire cerclage Early motion not always

possible

Novel plate-screw-stem fixation

Stability

Wire cerclage not always needed

No joint approach

Existing implants preserved

Early motion

Limited to locking stems Ideally requires a specially designed plate