# Salvage Treatment for a Periprosthetic Humeral Nonunion: A Case Report

## TL;DR

A 69-year-old woman with a failed elbow implant and bone deformity was successfully treated with a complex surgical procedure linking two implants via an allograft.

## Contribution

The paper introduces a novel surgical approach for periprosthetic humeral nonunions using allograft-composite linkage to a reverse shoulder implant.

## Key findings

- The patient showed successful recovery one year after the allograft-composite linkage surgery.
- The procedure is viable for periprosthetic fractures with multiple implants and bone deformity.
- This case supports the use of allografts in salvage treatments for complex upper extremity conditions.

## Abstract

The patient, a 69-year-old female, presented one year after receiving a total elbow arthroplasty with a nonunion periprosthetic fracture of the humerus. Due to the patient's severe osteoarthritis of the ipsilateral shoulder and significant humeral deformity, a procedure linking the total elbow arthroplasty to the reverse shoulder implant via a cemented allograft-composite linkage sleeve was performed. Previous literature suggests upper extremity salvage surgery using large-scale allografts is successful in treating large tumor or infection-derived defects, though data is lacking as to whether this treatment is effective in periprosthetic fractures in patients with significant comorbidities. This patient's success in the postoperative year supports the use of allograft-composite reconstruction followed by linkage to a reverse shoulder implant as a salvage treatment for periprosthetic fractures under certain conditions, such as multiple adjacent implants, bone deformity, and severe osteoarthritis.