关节镜下编织带缝线桥固定肱骨大结节骨折△

Arthroscopic fixation of humeral greater tuberosity fracture with Fiber Tape suture bridge

摘要:

[目的] 探讨关节镜下撬拨复位，编织带缝线桥固定技术治疗肱骨大结节骨折的疗效。[方法] 回顾性研究 2019 年 3 月—2021 年 1 月收治肱骨大结节骨折 10 例患者的临床资料，均采用关节镜下撬拨复位，编织带缝线桥固定技术治疗，分析临床疗效。[结果] 本组 10 例患者均顺利完成手术，术中无血管、神经损伤等严重并发症。10 例随访 13~28 个月，平均 (18.5±4.5) 个月。所有患者于术后 16~26 周 [平均 (20.1±3.0) 周] 恢复体力工作或运动。与术后 1 个月相比，末次随访时 VAS、ASES、Constant-Murley 评分，以及各方向 ROMs 均显著改善(P＜0.05)。术后即刻影像显示，10 例患者中，骨折复位优 9 例，良 1 例。所有患者均达到骨折愈合，无骨不连、肩峰下撞击等不良影像表现。[结论] 关节镜下撬拨解剖复位后，采用编织带缝线桥微创技术固定治疗肱骨大结节骨折创伤小，固定方式可靠，不切割肩袖组织，无需再手术内置物取出，术后疗效满意。

Abstract:

[Objective] To investigate the efficacy of arthroscopic reduction and Fiber Tape suture bridge fixation for humeral greater tuberosity fractures. [Methods] From March 2019 to January 2021, 10 patients with greater tuberosity fracture of the humerus were treated with arthroscopic reduction and Fiber Tape suture bridge fixation. [Results] All the 10 patients were successfully operated on without seri- ous complications such as vascular and nerve injury. Of them. 10 patients were followed up for 13 to 28 months, with an average of (18.5± 4.5) months. The patients resumed weight-bearing work or sports activity from 16 to 26 weeks with a mean of (20.1± 3.0) weeks after opera- tion. Compared with those at 1 month after surgery, the VAS, ASES and Constant-Murley scores, as well as ROMs in all directions signifi- cantly improved at latest follow-up (P＜0.05) . Radiographically, the fracture reduction quality was marked as excellent in 9 cases, good in 1 case, and poor in 0 case. By the time of latest follow up, all patients achieved fracture union without adverse imaging findings such as non- union and subacromial impingement. [Conclusion] This arthroscopic Fiber Tape suture bridge fixation is a reliable minimally invasive tech- nique for the treatment of humeral greater tuberosity fracture without cutting of rotator cuff tissue, and no need to remove the implant sec- ondarily, and does achieve satisfactory clinical outcomes.