Tae-Hwan Yoon1, Chong-Hyuk Choi1, Yun-Rak Choi1, Jong-Taek Oh1, Yong-Min Chun2. 1. Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: min1201@hanmail.net.
Abstract
BACKGROUND: The purpose of this study was to investigate clinical and radiologic outcomes of open reduction and internal fixation with a screw and washer for a displaced greater tuberosity fracture of the proximal humerus through a small incision. METHODS: We retrospectively reviewed 29 patients who underwent open reduction and internal fixation with a screw and washer for a greater tuberosity fracture of the proximal humerus. After surgery, the patients were immobilized in a brace for 4 weeks. To determine clinical outcomes, we evaluated a visual analog scale pain score; the Subjective Shoulder Value; the University of California, Los Angeles shoulder score; the American Shoulder and Elbow Surgeons score; and active range of motion. RESULTS: All patients achieved bone union within 3 months after surgery. At the 2-year follow-up, the mean visual analog scale pain score was 1.1 ± 1.1; Subjective Shoulder Value, 93.4 ± 5.3; University of California, Los Angeles shoulder score, 31.2 ± 2.7; and American Shoulder and Elbow Surgeons score, 92.6 ± 6.7. Mean active forward flexion, external rotation, and internal rotation were 144° ± 16°, 33° ± 11°, and 13.3 ± 1.7, respectively. Postoperatively, 9 patients (31%) had stiffness and pain refractory to conservative treatment and underwent arthroscopic release. CONCLUSION: Although minimal open reduction and screw and washer fixation resulted in bone union in all cases, the incidence of postoperative stiffness was relatively high in patients with displaced greater tuberosity fractures because of prolonged immobilization after surgery.
BACKGROUND: The purpose of this study was to investigate clinical and radiologic outcomes of open reduction and internal fixation with a screw and washer for a displaced greater tuberosity fracture of the proximal humerus through a small incision. METHODS: We retrospectively reviewed 29 patients who underwent open reduction and internal fixation with a screw and washer for a greater tuberosity fracture of the proximal humerus. After surgery, the patients were immobilized in a brace for 4 weeks. To determine clinical outcomes, we evaluated a visual analog scale pain score; the Subjective Shoulder Value; the University of California, Los Angeles shoulder score; the American Shoulder and Elbow Surgeons score; and active range of motion. RESULTS: All patients achieved bone union within 3 months after surgery. At the 2-year follow-up, the mean visual analog scale pain score was 1.1 ± 1.1; Subjective Shoulder Value, 93.4 ± 5.3; University of California, Los Angeles shoulder score, 31.2 ± 2.7; and American Shoulder and Elbow Surgeons score, 92.6 ± 6.7. Mean active forward flexion, external rotation, and internal rotation were 144° ± 16°, 33° ± 11°, and 13.3 ± 1.7, respectively. Postoperatively, 9 patients (31%) had stiffness and pain refractory to conservative treatment and underwent arthroscopic release. CONCLUSION: Although minimal open reduction and screw and washer fixation resulted in bone union in all cases, the incidence of postoperative stiffness was relatively high in patients with displaced greater tuberosity fractures because of prolonged immobilization after surgery.
Authors: Dylan R Rakowski; Joseph J Ruzbarsky; Thomas E Woolson; Marilee P Horan; Philip-C Nolte; Peter J Millett Journal: Arthrosc Sports Med Rehabil Date: 2022-02-23
Authors: Changbao Wei; Yongjun Rui; Yongwei Wu; Yunhong Ma; Ming Zhou; Yongqiang Kang; Yapeng Wang; Jun Liu Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2020-09-15