Dataset Information

Revision Arthroscopic Greater Tuberosity Fracture Fixation and Implant Removal: An Open to Arthroscopic Approach.

ABSTRACT: Failure of a greater tuberosity fracture fixation with screws can lead to stiffness, pain, and weakness of the rotator cuff. Management of a previously performed open greater tuberosity fracture fixation with screws involves implant removal and refixation of the fragment. Doing this arthroscopically in a previously performed open surgery has its own challenges but distinct advantages. Describe herein is a technique for performing this revision surgery arthroscopically.

SUBMITTER: Mhaskar VA

PROVIDER: S-EPMC7953265 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Revision Arthroscopic Greater Tuberosity Fracture Fixation and Implant Removal: An Open to Arthroscopic Approach.

Mhaskar Vikram Arun VA

Arthroscopy techniques 20210215 3

Failure of a greater tuberosity fracture fixation with screws can lead to stiffness, pain, and weakness of the rotator cuff. Management of a previously performed open greater tuberosity fracture fixation with screws involves implant removal and refixation of the fragment. Doing this arthroscopically in a previously performed open surgery has its own challenges but distinct advantages. Describe herein is a technique for performing this revision surgery arthroscopically. ...[more]

PMID: 33738221

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Project description:PurposeThe purpose of the study is to describe the functional and structural outcomes of the arthroscopic 4-strand, knotless, double-row construct with suture tapes for the surgical treatment of displaced and/or comminuted greater tuberosity fractures of the humerus.MethodsPatients were enrolled between December 2012 and January 2018. The main inclusion criteria were a comminuted and/or displaced tuberosity fracture with a displacement of at least 5 mm in any plane fixed under arthroscopy using a 4-strand, knotless, double-row construct. The technique involves reducing the displaced fragment with 2 medially placed, transtendinous anchors and compressing the greater tuberosity using the tapes from these medial anchors in 2 laterally placed anchors. The exclusion criteria were a fracture that was more than 10 days old at the time of surgery or a history of shoulder surgery and 3- or 4-part fractures. The postoperative rehabilitation protocol was similar for all patients. Constant scores, Quick Dash, return to work and sport, and complications were reported after a minimum follow-up period of 24 months. Bone healing was systematically evaluated on standardized radiographs, including lateral scapula view and anteroposterior views.ResultsTwenty-one patients were enrolled in this study. One patient did not complete the follow-up examination period and thus was excluded, leaving 20 patients in this study. At a median (SD) follow-up of 32 (9) months, the median (SD) Constant score was 94.7 (7.3) points, the median (SD) Quick Dash was 1.7 (4) points, and median (SD) visual analog scale score was 0.5 (1.4). All patients returned to previous work and sport level. No malunions or nonunions were seen. One conversion to open surgery was required for failure of the lateral row during surgery in a 62-year-old woman with osteopenic bone. Two patients experienced complex regional pain syndrome in the postoperative period that resolved after nonoperative treatment.ConclusionsIn this series, the use of arthroscopy combined with the biomechanical properties of knotless double-row constructs contributed to postoperative satisfactory functional results and healing of greater tuberosity fracture. In addition, range of motion was early, and no hardware removal was required. However, care should be taken with osteopenic bone where anchorage can fail.Level of evidenceLevel IV, case series.

Dataset Information

Revision Arthroscopic Greater Tuberosity Fracture Fixation and Implant Removal: An Open to Arthroscopic Approach.

Publications

Revision Arthroscopic Greater Tuberosity Fracture Fixation and Implant Removal: An Open to Arthroscopic Approach.

Similar Datasets

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