El Rassi Georges, Aouad Dany, Ayoubi Rami, Darwish Mohammad, Saidy Elias, Maalouly Joseph
St Georges University Medical Center, Beirut, Lebanon.
Arthrosc Tech. 2021 Jan 20;10(1):e139-e144. doi: 10.1016/j.eats.2020.09.024. eCollection 2021 Jan.
Isolated greater tuberosity fractures with displacement require usually open reduction and fixation to prevent poor outcomes, but high levels of morbidity have been reported. Recently, newer techniques describe arthroscopic fixation of greater tuberosity fracture for young patients; however, in elderly patients with comminuted osteoporotic fractures, this entity is more complex. A new arthroscopic technique is described through a minimally invasive approach that allows the evaluation of the glenohumeral joint and the treatment of associated pathology. These comminuted fractures can be treated using suture bridge technique. Postoperatively, rehabilitation consists of a similar regimen to that of a rotator cuff repair. With the appropriate surgical technique, good clinical outcomes can be obtained.
孤立性伴有移位的大结节骨折通常需要切开复位内固定以防止预后不佳,但已有报道称其并发症发生率较高。近来,有新的技术描述了针对年轻患者的大结节骨折的关节镜下固定;然而,对于患有粉碎性骨质疏松性骨折的老年患者,情况更为复杂。本文描述了一种通过微创入路的新关节镜技术,该技术可用于评估盂肱关节并治疗相关病变。这些粉碎性骨折可用缝线桥接技术治疗。术后康复方案与肩袖修复术后相似。采用合适的手术技术可获得良好的临床疗效。