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解剖学上的大结节愈合并不影响急性肱骨近端骨折的反肩关节置换术的功能结果。

Anatomic greater tuberosity healing does not influence the functional outcomes of reverse shoulder arthroplasty for acute proximal humerus fractures.

作者信息

Cassart Masnou E, Pérez Andrés R, Mora Solé E, García Perdomo D, Ruiz Macarrilla L

机构信息

Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

出版信息

Shoulder Elbow. 2023 Nov;15(3 Suppl):60-68. doi: 10.1177/17585732221089864. Epub 2022 Apr 4.

Abstract

BACKGROUND

To investigate the functional outcomes of reverse shoulder arthroplasty (RSA) in acute complex proximal humerus fractures (PHF) in patients with an anatomic greater tuberosity union in comparison to patients with a displaced or resorbed tuberosity.

METHOD

It is a retrospective study with prospective data collection including 32 consecutive PHF with a minimum two-year follow-up treated with RSA. A radiological study and a CT scan were performed specifically for the study. Two shoulder surgeons and a musculoskeletal radiologist assessed the position and union of the greater tuberosity. The functional outcomes were assessed with the Constant-Murley, DASH, ASES and ADLER scores.

RESULTS

The mean overall CS was 59.55. In 17 cases, the greater tuberosity healed in an anatomical position. In 15 cases, it was non-anatomical. In 53% of patients, greater tuberosity union was obtained. The CS was 62.76 in the anatomic union group and 55.9 in the non-anatomic union group. No significant differences were observed. No differences were observed in the ASES, DASH and ADLER scores.

CONCLUSION

After RSA for PHF, anatomic greater tuberosity healing was obtained in 53% of patients. The influence of the position and union of the greater tuberosity on the functional results could not be evidenced.

摘要

背景

探讨在解剖学上大结节愈合的患者与大结节移位或吸收的患者相比,反向肩关节置换术(RSA)治疗急性复杂性肱骨近端骨折(PHF)的功能结果。

方法

这是一项回顾性研究,前瞻性收集数据,包括32例连续接受RSA治疗且至少随访两年的PHF患者。专门为该研究进行了放射学研究和CT扫描。两名肩关节外科医生和一名肌肉骨骼放射科医生评估了大结节的位置和愈合情况。使用Constant-Murley、DASH、ASES和ADLER评分评估功能结果。

结果

总体平均Constant-Murley评分为59.55。17例患者大结节在解剖位置愈合。15例患者大结节愈合位置非解剖学位置。53%的患者实现了大结节愈合。解剖学愈合组的Constant-Murley评分为62.76,非解剖学愈合组为55.9。未观察到显著差异。ASES、DASH和ADLER评分也未观察到差异。

结论

PHF患者接受RSA治疗后,53%的患者实现了大结节解剖学愈合。大结节的位置和愈合情况对功能结果的影响未得到证实。

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