Excellent clinical and radiological outcomes after arthroscopic reduction and double row-suture bridge for large-sized greater tuberosity fractures of the humerus

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-10-15 DOI:10.1002/ksa.12506

Sang-Hun Ko, Jaemin Oh, Ki-Bong Park, Sangheon Oh, Young Dae Jeon

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Abstract

Purpose

Currently, there is limited information on the clinical outcomes of arthroscopic reduction and double-row suture bridge fixation for large greater tuberosity fractures of the proximal humerus. This study aimed to evaluate the radiological and clinical outcomes of arthroscopic reduction and double-row suture bridge fixation for these fractures, hypothesizing that arthroscopic reduction and double-row suture bridge fixation is a safe, effective and minimally invasive treatment for large greater tuberosity fractures.

Methods

This retrospective study analysed patients with large greater tuberosity fractures (fracture fragment ≥30 mm in diameter) who underwent arthroscopic reduction and double-row suture bridge fixation and had a follow-up period exceeding 2 years. The anatomic reduction was confirmed by assessing the step-off on radiographs immediately after surgery, and the radiologic union time was recorded. At the final follow-up, range of motion and functional outcome scores were evaluated. Additionally, any surgery-related complications were evaluated.

Results

Fifteen patients with a mean follow-up of 57.7 ± 23.1 months were included in the study. The mean fracture fragment size was 32.5 ± 2.4 mm, with a mean displacement of 5.1 ± 1.6 mm. Immediately postsurgery, 13 of 15 patients (86.7%) had a fracture step-off of <3 mm, with an average union time of 3 months. At the final follow-up, patients demonstrated excellent outcomes, with an average forward flexion of 167 ± 9.7° and external rotation of 70 ± 16.3. Functional outcome scores showed significant improvement compared with preoperative scores (p < 0.001). No major surgery-related complications were reported.

Conclusions

Arthroscopic reduction and double-row suture bridge fixation for large-sized greater tuberosity fractures is safe and shows good fracture reduction and excellent clinical outcomes. Therefore, this surgical method can be considered an alternative to open reduction for large greater tuberosity fractures.

Level of Evidence

Level IV.

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对肱骨大结节骨折进行关节镜复位和双行缝合桥接术后，临床和放射学效果极佳。

目的：目前，关于肱骨近端大结节骨折的关节镜下复位和双排缝合桥固定的临床疗效的信息十分有限。本研究旨在评估关节镜下复位和双排缝合桥固定治疗此类骨折的放射学和临床疗效，并假设关节镜下复位和双排缝合桥固定是治疗肱骨近端大结节骨折的一种安全、有效和微创的治疗方法：这项回顾性研究分析了大结节骨折（骨折片直径≥30毫米）患者，这些患者接受了关节镜下复位和双排缝合桥固定术，随访时间超过2年。术后立即通过 X 光片评估阶梯截骨情况，确认解剖复位，并记录放射学结合时间。在最后的随访中，对患者的活动范围和功能结果进行了评估。此外，还对手术相关并发症进行了评估：研究共纳入了 15 名患者，平均随访时间为（57.7 ± 23.1）个月。平均骨折片大小为（32.5 ± 2.4）毫米，平均移位为（5.1 ± 1.6）毫米。手术后，15 名患者中有 13 名（86.7%）的骨折断端立即得出结论：关节镜下大结节骨折复位和双排缝合桥固定术是一种安全的手术方法，具有良好的骨折复位效果和临床疗效。因此，这种手术方法可被视为大结节骨折切开复位术的替代方法：证据等级：IV 级。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).