Summary
Clinical analysis of treatment of arthroscopic assisted reduction suture bridge fixation VS open reduction screw fixation for displaced greater tuberosity of humerus fractures
Abstract
Object: Arthroscopic assisted reduction suture bridge fixation and open reduction screw fixation for displaced greater tuberosity of humerus fractures are two principal surgical methods at present.However,that which is the better one needs to be explored.
Methods
35 patients with displaced greater tuberosity of humerus fractures were included in our study(the displacement of fracture is greater than 5mm and the bone block is less than 2 * 2cm, without surgical neck or anatomical neck of humerus fractures) from 2008 to 2015. 15 cases (43%, group 1) with the arthroscopic assisted reduction suture bridge fixation and the other 20 cases (57%, group 2) with open reduction and hollow screw internal fixation. Of which, 11 cases of group 1 and 12 cases of group 2 were followed up at 6 weeks,12 weeks, 24 weeks and then half a year after surgery.The average follow-up time was 23 months (13-38 months). Statistics data include surgery time, healing time after operation, the range of motion of the shoulder,visual analogue score(VAS), American Shoulder and Elbow Surgeons (ASES) score, and related complications.
Results
Patients who underwent arthroscopic suture bridge fixation had longer surgical times than did patients who underwent open reduction and internal fixation (mean, 96.4 minutes, SD, 12.3 minutes vs mean, 58.5 minutes, SD, 7.2 minutes; P< 0.001), All patients achieved bone union within 3 months. Compared with goup2, the patients of group 1 had greater ranges of forward flexion (mean, 150.3 ° , SD, 11.3° VS mean,132.5° SD, 13.2; P = 0.031), and abduction (mean, 143.3 ° , SD, 14.4 ° VS mean,126.4°, SD, 18.5°; P = 0.046), and higher AESE score (mean, 90.8, SD, 4.1 vs mean, 82.4, SD, 4.8; P = 0.018); Secondary subacromial impingement occurred in 3 cases of group 2 and received reoperation to remove the implants and acromioplasty. One postoperative stiffness and one case of greater tuberosity atrophy and the displaced implant was recorded in group 2.
Conclusion
We suggest that arthroscopic suture bridge fixation is better than open reduction and internal fixation in minimally invasiveness and postoperative limb function recovery for displaced greater tuberosity of humerus fractures.