Velasquez Garcia Ausberto, Abdo Glen, Ingala Martini Liborio
Department of Orthopedic Surgery, Clinica Universidad de Los Andes, Santiago, Chile.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Arthrosc Tech. 2023 Feb 13;12(3):e349-e355. doi: 10.1016/j.eats.2022.11.014. eCollection 2023 Mar.
Over the past years, several arthroscopic fixation procedures have been adopted for fractures of the greater tuberosity. Although they offer advantages over open approaches, especially for avulsion-type fixation, split-type fractures are usually treated with open reduction and internal fixation. However, suture constructs can result in a more reliable fixation system for multifragment or osteoporotic split-type fractures. Currently, the use of arthroscopic techniques in these more complex fractures is questionable due to inherent limitations of anatomic reduction and stability concerns. The authors report a technically simple and reproducible arthroscopic procedure based on anatomic, morphologic, and biomechanical concepts, which offers advantages over traditional open approaches or double-row arthroscopic techniques in the treatment of most split-type greater tuberosity fractures.
在过去几年中，几种关节镜下固定手术已被应用于大结节骨折。尽管它们相对于开放手术具有优势，特别是对于撕脱型固定，但劈裂型骨折通常采用切开复位内固定治疗。然而，缝线结构可为多块或骨质疏松性劈裂型骨折提供更可靠的固定系统。目前，由于解剖复位的固有局限性和稳定性问题，在这些更复杂的骨折中使用关节镜技术存在疑问。作者报告了一种基于解剖学、形态学和生物力学概念的技术上简单且可重复的关节镜手术，该手术在治疗大多数劈裂型大结节骨折方面比传统开放手术或双排关节镜技术具有优势。
