Periprosthetic Upper Extremity Fractures

Accreditation Statement: The Orthopaedic Trauma Association (OTA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation:  OTA designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME of the American Board of Orthopaedic Surgery’s Maintenance of Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABOS credit.

MOC Claim Credit Deadline: 6/24/2029

Learning Objectives:

After completing this activity, learners will be able to:

1. Determine stability of the prosthetic implant involved in the fracture and assess how this affects treatment strategies.

2. Develop surgical algorithms and techniques that focus on fixation allowing for early motion.

3. Predict treatment sequalae and complications following treatment so can build back up/revision strategies.

Faculty:

• Moderator: Augustine Saiz, MD
• Andrew Choo, MD
• Jonah Davies, MD
• Jennifer Tangtiphaiboontana, MD

Original release date: 6/24/2026

Expiration date: 6/24/2029

Estimated time to complete activity: 1 hour

Statement of Need/Description/or Summary of Gap Analysis

With increasing population of patients undergoing upper extremity arthroplasty, there has been an increase in periprosthetic fractures involving the scapula, humerus, elbow, and forearm. Orthopaedic surgeons need to recognize these distinct patterns, understand the importance of fixation allowing for early range of motion, and be familiar with surgical concepts in treatment.

Upper extremity arthroplasty is becoming more specialized amongst Shoulder and Elbow fellowships and surgeons. However, the subsequent fractures live in a shared/nebulous space. As orthopaedic trauma surgeons are specialized in fracture care and these fractures present through the ER or trauma setting, ortho trauma surgeons are often tasked with treating them. Given this gap in training between the two fellowships, familiarity with prostheses and crossover fractures is less common. However, with some basic knowledge and algorithms, these fractures can be successfully treated.

Method of Participation: There are no fees for members to participate in this activity. Non-members must pay $40. To participate in the activity, physicians will be required to take the following steps:

• Read the learning objectives and faculty disclosures.
• Participate in the activity.
• Complete the activity evaluation.
• Participants who successfully complete the evaluation will receive AMA PRA Category 1 Credits™.

Disclosures:

The Orthopaedic Trauma Association has implemented a policy to comply with the current Accreditation Council for Continuing Medical Education (ACCME) Standards for Integrity and Independence in Accredited Continuing Education requiring mitigation of all conflicts of interest. Faculty declaring a relevant commercial interest must be identified in the activity syllabus and/or program.

In accordance with disclosure policies of OTA and the ACCME, every effort has been made to ensure all CME activities are balanced, independent, objective, and scientifically rigorous. These policies include complying with ACCME’s Standards for Integrity and Independence in Accredited Continuing Education and mitigating all relevant conflicts of interest for all individuals in control of content.  

All of the relevant financial relationships listed for these individuals have been mitigated

Disclosures are available on the "Disclosure" tab.

Disclaimer: The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by the OTA.  In no event will the OTA be liable for any decision made or action taken in reliance upon the information provided through this CME activity.

Commercial Support: There is no commercial support for this activity