Surgical Management of Periprosthetic Scapular Spine and Acromion Fractures

Abstract

Periprosthetic fractures of the acromion and scapular spine have been reported increasingly as an early complication of reverse shoulder arthroplasty (RSA). The mechanics of RSA, which involves medializing the center of rotation and lengthening the moment arm for the deltoid muscle, increases the load on the acromion and subsequently the risk for postoperative fatigue fractures. The modification of the original Grammont design with a more lateralized construct seems to increase the incidence of this complication. Other authors have associated this with the superior or posterior screw of the glenoid baseplate inserted toward the scapular spine, impingement of the greater tuberosity on the acromion on abduction, or history of traumatic fall.