Concurrent Revision Reverse Total Shoulder Arthroplasty and Scapular Spine ORIF for Periprosthetic Fractures: A Report of 2 Cases Using a Dual-Strategy Solution.

CASE: Two septuagenarian women presented with chronic periprosthetic scapular spine fractures after reverse total shoulder arthroplasty (RTSA) placement. Preoperative radiographs revealed a displaced unstable scapular spine fracture with scapula notching and onlay humeral position. One case additionally demonstrated uptilted baseplate placement. Both patients underwent concurrent revision RTSA with fixation of the scapular spine to correct component malposition and reduce glenohumeral tension. At 27-month follow-up, both achieved radiographic union, pain reduction, and functional gains without complications. CONCLUSION: The authors present a novel strategy to correct the underlying biomechanical stressors of an overtensioned RTSA construct while stabilizing the scapular spine fractures, resulting in excellent healing and functional recovery.