Over the past years, several arthroscopic fixation procedures have been adopted for fractures of the greater tuberosity. Although they offer advantages over open approaches, especially for avulsion-type fixation, split-type fractures are usually treated with open reduction and internal fixation. However, suture constructs can result in a more reliable fixation system for multifragment or osteoporotic split-type fractures. Currently, the use of arthroscopic techniques in these more complex fractures is questionable due to inherent limitations of anatomic reduction and stability concerns. The authors report a technically simple and reproducible arthroscopic procedure based on anatomic, morphologic, and biomechanical concepts, which offers advantages over traditional open approaches or double-row arthroscopic techniques in the treatment of most split-type greater tuberosity fractures.
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http://dx.doi.org/10.1016/j.eats.2022.11.014 | DOI Listing |
J Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Background: Isolated fractures of the greater tuberosity represent up to 20% of all proximal humeral fractures. Conservative and surgical treatment strategies are reported. Fracture displacement on radiographs is a key factor in treatment decisions, but the accuracy of measurement methods can limit this process.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Department of Mechanical & Aerospace Engineering, University of Florida, 330MAE-A P.O. Box 116250, Gainesville, FL, USA 32611.
Background: Postoperative assessment following reverse total shoulder arthroplasty (rTSA) typically involves plain radiographs to evaluate implant positioning parameters, such as humeral distalization and lateralization along with medialization and distalization of the center of rotation (COR). However, the precision of these radiographic measurements remains unclear. This study aimed to validate the accuracy of radiographic two-dimensional (2D) measurements compared to three-dimensional (3D) surface model-based measurements derived from CT data for evaluating postoperative parameters in rTSA.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia.
Purpose: To evaluate the minimum 12-month clinical and radiological outcomes of combined superior capsular reconstruction (SCR) and lower trapezius transfer (LTT) for posterosuperior irreparable massive rotator cuff tears (IMRCTs).
Methods: Patients with posterosuperior IMRCTs and severe fatty infiltration (Goutallier grades 3 or more) in the infraspinatus who underwent SCR +LTT were retrospectively reviewed. A double-folded fascia lata autograft with one layer of polypropylene mesh inside was used for SCR and an Achilles tendon allograft was used to connect the tendon of lower trapezius to the greater tuberosity.
J Orthop Case Rep
December 2024
Department of Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
Introduction: Proximal humerus fractures are prevalent, especially among the elderly, and pose significant challenges in treatment, particularly for displaced fractures. Despite the availability of various surgical techniques, outcomes remain inconsistent, often due to poor anatomical reduction and fixation. This study examines the correlation between specific radiographic parameters and functional outcomes, aiming to identify key predictors of recovery.
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