Ko Sang-Hun, Oh Jaemin, Park Ki-Bong, Oh Sangheon, Jeon Young Dae
Department of Orthopaedic Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2025 Apr;33(4):1500-1506. doi: 10.1002/ksa.12506. Epub 2024 Oct 15.
Currently, there is limited information on the clinical outcomes of arthroscopic reduction and double-row suture bridge fixation for large greater tuberosity fractures of the proximal humerus. This study aimed to evaluate the radiological and clinical outcomes of arthroscopic reduction and double-row suture bridge fixation for these fractures, hypothesizing that arthroscopic reduction and double-row suture bridge fixation is a safe, effective and minimally invasive treatment for large greater tuberosity fractures.
This retrospective study analysed patients with large greater tuberosity fractures (fracture fragment ≥30 mm in diameter) who underwent arthroscopic reduction and double-row suture bridge fixation and had a follow-up period exceeding 2 years. The anatomic reduction was confirmed by assessing the step-off on radiographs immediately after surgery, and the radiologic union time was recorded. At the final follow-up, range of motion and functional outcome scores were evaluated. Additionally, any surgery-related complications were evaluated.
Fifteen patients with a mean follow-up of 57.7 ± 23.1 months were included in the study. The mean fracture fragment size was 32.5 ± 2.4 mm, with a mean displacement of 5.1 ± 1.6 mm. Immediately postsurgery, 13 of 15 patients (86.7%) had a fracture step-off of <3 mm, with an average union time of 3 months. At the final follow-up, patients demonstrated excellent outcomes, with an average forward flexion of 167 ± 9.7° and external rotation of 70 ± 16.3. Functional outcome scores showed significant improvement compared with preoperative scores (p < 0.001). No major surgery-related complications were reported.
Arthroscopic reduction and double-row suture bridge fixation for large-sized greater tuberosity fractures is safe and shows good fracture reduction and excellent clinical outcomes. Therefore, this surgical method can be considered an alternative to open reduction for large greater tuberosity fractures.
Level IV.
目前，关于关节镜下复位及双排缝线桥固定治疗肱骨近端大结节骨折的临床疗效的信息有限。本研究旨在评估关节镜下复位及双排缝线桥固定治疗这些骨折的影像学和临床疗效，假设关节镜下复位及双排缝线桥固定是治疗大结节骨折的一种安全、有效且微创的方法。
本回顾性研究分析了接受关节镜下复位及双排缝线桥固定且随访时间超过2年的大结节骨折（骨折块直径≥30mm）患者。术后即刻通过评估X线片上的台阶来确认解剖复位，并记录骨折愈合时间。在末次随访时，评估活动范围和功能结果评分。此外，评估任何与手术相关的并发症。
15例患者纳入研究，平均随访时间为57.7±23.1个月。平均骨折块大小为32.5±2.4mm，平均移位为5.1±1.6mm。术后即刻，15例患者中有13例（86.7%）骨折台阶<3mm，平均愈合时间为3个月。在末次随访时，患者显示出良好的结果，平均前屈为167±9.7°，外旋为70±16.3°。功能结果评分与术前评分相比有显著改善（p<0.001）。未报告重大手术相关并发症。
关节镜下复位及双排缝线桥固定治疗大型大结节骨折是安全的，显示出良好的骨折复位和优异的临床疗效。因此，这种手术方法可被视为大型大结节骨折切开复位的一种替代方法。
四级。
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