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Shuttle Suture Technique for Passing Rotator Cuff Suture Through the Plate Eyelet Holes in Proximal Humerus Fixation.

ABSTRACT: The proximal humerus fracture is common in both adult and elderly patients, with an incidence of approximately 5%, of whom about 1 in 4 is treated operatively. To achieve the healing of the fracture, the operative technique is combined with an internal fixation by a locking plate and tension band rotator cuff sutures by passing the sutures through each eyelet hole of the plate and tightening them. The tension band rotator cuff sutures provide good functional and radiographic outcomes in cases of proximal humerus fracture. The surgeons normally pass a rotator cuff suture through each eyelet hole using a curved needle which can pass only one suture in one eyelet hole. We propose a shuttle suture technique to easily pass the rotator cuff sutures through the eyelet holes of the locking plate.

SUBMITTER: Klabklay P

PROVIDER: S-EPMC7823115 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Arthroscopic Repair of Rotator Cuff Tears Using a Suture Hook With Lasso Loop for Forward Suture Passing

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All-Suture Transosseous Repair for Rotator Cuff Tear Fixation Using Medial Calcar Fixation.

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An augmentation suture technique for arthroscopic rotator cuff repair.

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How to Maximize Suture Tension in Double-Row Suture-Bridge Rotator Cuff Repair?

Project description:Double-row suture-bridge technique for rotator cuff repair has been used for rotator cuff tears. In large tears that require 2 or more lateral row anchors, loosening of the suture bridges could occur because of tightening sequence. By retightening suture limbs before deploying the first lateral row anchor, premature loosening could be prevented and enhance the tension of the construct.

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Factors associated with maintaining reduction following locking plate fixation of proximal humerus fractures: a population-based retrospective cohort study.

Project description:BackgroundLoss of reduction (LoR) can occur after locking plate fixation of proximal humerus fractures (PHFs). This study determined biomechanical features of fracture fixation associated with preventing LoR postoperatively. One-year reoperation rates were also compared between those with/without LoR.MethodsPopulation-based administrative data for 359 adults treated using a locking plate for PHF between 2010 and 2016 were examined. Two trained assessors reviewed standardized shoulder radiographs. LoR (Yes/No) was defined as any fracture displacement >0.5 cm, and/or >10° change in neck-shaft angle (NSA) alignment relative to intraoperative imaging. Multiple logistic regression assessed how the following affected maintaining reduction: (1) sex, (2) age, (3) Neer classification, (4) shaft impaction (SI), (5) shaft medialization (SM), (6) calcar reduction (CR), (7) NSA alignment, and (8) screw use.ResultsLoR was seen in 79 (22%) patients. LoR was significantly associated with increasing age (odds ratio [OR] = 1.06/yr, P < .001), fracture severity (4-part vs. 2-part fracture; OR = 4.63, P = .001), and varus NSA alignment (<125° vs. ≥145°: OR = 5.6, P = .02; <125° vs. 125-145°, OR = 2.2, P = .02]). Patients achieving simultaneous SI, SM, and CR were significantly less likely (OR = 0.009, P < .001) to lose reduction, after controlling for age, fracture severity, and NSA alignment. If only SI was achieved, patients were still significantly less likely to lose reduction relative to achieving none of these mechanical features (OR = 0.17, P = .006). Reoperations were higher when LoR occurred (n = 26/77 [33.4%]) compared with no LoR (n = 20/276 [7.2%]) (P < .001).ConclusionsSI was strongly associated with preventing LoR in patients treated using a locking plate for PHF. SI with concurrent SM, CR, and a neutral or valgus NSA had the lowest rates of LoR. LoR was associated with higher rates of reoperation.

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Postoperative malrotation of humerus shaft fracture causes degeneration of rotator cuff and cartilage.

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