Arthroscopic reduction and fixation for displaced greater tuberosity fractures using the modified suture-bridge technique

Int Orthop. 2017 Jun;41(6):1257-1263. doi: 10.1007/s00264-017-3461-y. Epub 2017 Apr 11.

Abstract

Purpose: The aim of this study was to evaluate the early clinical outcomes of arthroscopic treatment of avulsion or comminuted fractures of the greater tuberosity (GT) using a modified suture-bridge technique.

Methods: Between February 2013 and November 2015, 14 patients with displaced or comminuted fractures of GT were arthroscopically treated using a modified suturebridge technique. Displacement of the GT fragments was > 3 mm in any plane. An analysis of follow-up results including the University of California, Los Angeles (UCLA) shoulder scale; the shoulder index of the American Shoulder and Elbow Surgeons (ASES); the simple shoulder test (SST); and shoulder range of motion (ROM), is presented.

Results: Mean duration of follow up is 18.9 months (range, 6-30). Mean age of patients was 62.9 years (range, 49-74). Postoperatively, the outcomes were rated as excellent, good and fair in two, 11 and one patient, respectively based on the UCLA score. At the most recent follow-up, the average UCLA score increased to 32 points, the ASES score increased to 97.5 points, and the SST score increased to 11 points. Average forward flexion was 153.6°, average abduction was 158.6°, average external rotation in the neutral position was 38.6°, and internal rotation increased to the 12th thoracic vertebral level.

Conclusion: Early follow-up outcomes of the arthroscopic modified suture-bridge technique used for avulsion or comminuted GT fractures are promising. The technique can be used as one of the therapeutic modalities for GT fractures.

Keywords: Arthroscopic modified suture-bridge technique; Avulsion or comminuted GT fractures.

MeSH terms

  • Aged
  • Arthroscopy / methods*
  • Female
  • Follow-Up Studies
  • Fracture Fixation / methods*
  • Fractures, Comminuted / surgery*
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Recovery of Function
  • Shoulder Fractures / surgery*
  • Shoulder Joint / surgery
  • Suture Techniques / adverse effects*
  • Sutures
  • Treatment Outcome