Department of Orthopaedic Surgery, The Second Affiliated Hospital of Fujian Medical University, No.34, Zhongshanbeilu, Quanzhou, 36200, Fujian, China.
J Orthop Surg Res. 2020 Nov 23;15(1):554. doi: 10.1186/s13018-020-02077-8.
Patients with greater tuberosity fractures of the humerus often require surgery. Therefore, there is a need to find a minimally invasive and effective surgical procedure with great patient outcomes.
To evaluate the clinical outcomes of the W-shaped suture technique under shoulder arthroscopy in the treatment of greater tuberosity fractures of the humerus.
In this retrospective study, a total of 17 patients were included. The fractures were closed, and there was no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation of the greater tuberosity fractures. Fixation was performed using sighting nails combined with a W-shaped suture. The imaging data of the patients were collected, and the ASES score, Constant-Murley score, and VAS score were used to evaluate the patient's outcome. At the last follow-up (at least 1 year), the range of motion in the affected shoulder was compared with that of the contralateral side.
The operation was successful in all the patients. The average follow-up time was 13 months. There were no reported complications such as fracture displacement, nonunion, and internal fixation failure during the follow-up period. Post-operative X-ray examinations revealed good function recovery, with a healing time of between 10 and 12 weeks, and an average healing time of 11.5 weeks. Following the operation, patients reported reduced shoulder joint pain that no longer influenced their activity or caused discomfort in their daily life. The patient's VAS score ranged from 0 to 3, with an average of 0.52 ± 0.73, while at the last follow-up, the Constant-Murley score ranged from 83 to 97, with an average of 92.33 ± 7.55. The ASES score ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the overall range of motion with the unaffected limb.
This study demonstrates that the W-shaped suture can be used to effectively fix the fractures of the greater tuberosity of the humerus, by increasing the fixed area to promote healing.
肱骨大结节骨折的患者常需手术治疗，因此，需要寻找一种微创且疗效确切的手术方式。
评估关节镜下 W 形缝合技术治疗肱骨大结节骨折的临床疗效。
回顾性分析 17 例闭合性、无神经血管损伤的肱骨大结节骨折患者，均采用关节镜辅助下复位内固定治疗。采用导针结合 W 形缝线固定。术后通过影像学评估，采用美国肩肘外科协会（ASES）评分、Constant-Murley 评分、视觉模拟评分（VAS）评估患者肩关节功能。末次随访（至少 1 年）时，比较患侧与健侧肩关节活动度。
所有患者手术均顺利完成，平均随访 13 个月。随访期间未发生骨折移位、骨不连、内固定失败等并发症。术后 X 线检查显示骨折愈合良好，愈合时间为 1012 周，平均愈合时间为 11.5 周。术后患者肩关节疼痛明显缓解，不影响日常活动，VAS 评分为 03 分，平均 0.52±0.73 分；末次随访时 Constant-Murley 评分为 8397 分，平均 92.33±7.55 分；ASES 评分为 8198 分，平均 93.15±6.93 分。末次随访时患侧与健侧肩关节总活动度比较差异无统计学意义。
W 形缝线可增加固定面积，促进愈合，有效固定肱骨大结节骨折。
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