Great tuberosity fixation does not affect healing and clinical outcomes in RSA performed in proximal humeral fractures in elderly patients.

Q1 Medicine

MUSCULOSKELETAL SURGERY Pub Date : 2024-03-01 Epub Date: 2024-01-04 DOI:10.1007/s12306-023-00807-9

Giuseppe Porcellini, Marta Montanari, Andrea Giorgini, Gian Mario Micheloni, Rocco Bonfatti, Luigi Tarallo

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引用次数: 0

Abstract

Purpose: Aims of our study were to define whether the great tuberosity (GT) positioning fixation in reverse shoulder arthroplasty (RSA) after proximal humeral fracture (PHF) could predict tuberosity healing and its impact on clinical outcomes.

Methods: We enrolled 59 patients treated with cementless reverse shoulder arthroplasty after PHF in our institute between 2012 and 2018. The mean follow-up was 57 months (± 23.4). We divided patients into two groups according to GT positioning after fixation: Group 1 GT in contact and Group 2 GT detached at least 1 mm from humeral diaphysis. Clinical and radiographic evaluations were conducted at last follow-up.

Results: Overall GT healing rate was 64.4%, (Group 1 70.7%-Group 2 50%). A statistically significant difference (P = 0.047) was found in cortical thickness narrowing at one-third of stem length. We found a correlation between lateral cortical narrowing and GT fixation in non-anatomical position, but we observed no statistically significant differences about GT healing according to GT anatomical or non-anatomical fixation. No differences were found in shoulder function in patients whose tuberosity was healed or failed to heal.

Conclusion: GT reduction is not a predictive factor for GT healing; external stress shielding, instead, seems to be decreased in patients with postoperative anatomically reduced GT. In our study, GT healing did not affect clinical outcomes or patient's satisfaction in elderly low-demanding patients.

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在老年患者肱骨近端骨折的 RSA 治疗中，大结节固定不会影响愈合和临床效果。

目的：我们的研究旨在明确肱骨近端骨折（PHF）后反向肩关节置换术（RSA）中大结节（GT）定位固定能否预测结节愈合及其对临床结果的影响：我院在2012年至2018年间共收治了59例PHF后行无骨水泥反向肩关节置换术的患者。平均随访时间为 57 个月（± 23.4）。我们根据GT在固定后的位置将患者分为两组：第一组 GT 接触，第二组 GT 与肱骨干骺端分离至少 1 mm。最后一次随访时进行临床和放射学评估：GT总愈合率为64.4%（第一组70.7%，第二组50%）。骨干长度三分之一处皮质厚度变窄，差异有统计学意义（P = 0.047）。我们发现外侧皮质变窄与非解剖位置的GT固定存在相关性，但我们观察到GT愈合与GT解剖或非解剖固定在统计学上没有显著差异。结节愈合或未愈合患者的肩关节功能没有差异：结论：GT缩小并不是GT愈合的预测因素；相反，术后GT解剖学缩小的患者的外应力屏蔽似乎会降低。在我们的研究中，GT愈合并不影响老年低需求患者的临床效果或患者满意度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

MUSCULOSKELETAL SURGERY Medicine-Surgery

CiteScore

4.50

自引率

0.00%

发文量

期刊介绍： Musculoskeletal Surgery – Formerly La Chirurgia degli Organi di Movimento, founded in 1917 at the Istituto Ortopedico Rizzoli, is a peer-reviewed journal published three times a year. The journal provides up-to-date information to clinicians and scientists through the publication of original papers, reviews, case reports, and brief communications dealing with the pathogenesis and treatment of orthopaedic conditions.An electronic version is also available at http://www.springerlink.com.The journal is open for publication of supplements and for publishing abstracts of scientific meetings; conditions can be obtained from the Editors-in-Chief or the Publisher.