[ARTHROSCOPOIC FIXATION WITH PERCUTANEOUS CANNULATED SCREWS FOR ACUTE DISPLACED ISOLATED GREATER TUBEROSITY FRACTURES OF THE PROXIMAL HUMERUS].

OBJECTIVE

To evaluate the technique and the effectiveness of arthroscopic fixation with percutaneous cannulated screws for acute displaced isolated greater tuberosity fractures of the proximal humerus.

METHODS

A retrospective analysis was made on the clinical data of 15 patients with acute displaced isolated greater tuberosity fractures of the proximal humerus, who accepted arthroscopic percutaneous cannulated screw fixation treatment between January 2010 and February 2013. There were 8 males and 7 females with an average age of 44.9 years (range, 31-66 years). Eight left shoulders and 7 right shoulders were affected. The mean interval of injury and operation was 9.9 days (range, 4-19 days). Before operation, the average range of motion (ROM) values of the affected shoulder were (74.13 ±17.19)° in forward flexion, (121.67 ± 17.50)° in abduction, (T11 ± 2)° in internal rotation, and (39.27 ± 8.08)° in external rotation; the visual analogue scale (VAS) score was 6.46 ± 1.30; and Costant score was 62.27 ± 11.90.

RESULTS

Operations were all successfully completed and incision healed by first intention in all cases. All cases were followed up 12-27 months (mean, 15 months). Postoperative X-ray films showed good reduction, alignment, and union of fracture. The average fracture healing time was 8 weeks (range, 6-13 weeks). At last follow-up, the ROM of the affected shoulder were significantly improved to (169.33 ± 7.99)° in forward flexion, (156.67 ± 10.47)° in abduction, (T6 ± 2)° in internal rotation, and (71.67 ± 7.94)° in external rotation (P < 0.05); the VAS score was significantly reduced to 1.73 ± 1.02 (t = -8.51, P = 0.00); and the Costant score was significantly increased to 96.20 ± 2.34 (t = 11.50, P = 0.00). No complication was found, such as neural or vascular injury, infection, shoulder joint adhesion, fixation failure, or fracture displacement.

CONCLUSION

Arthroscopic fixation with percutaneous cannulated screws is a safe method to treat acute displaced isolated greater tuberosity fractures of the proximal humerus, and it has good short-term effectiveness with the advantages of little trauma and satisfactory functional recovery.