A clinical analysis of single row anchor combined with bone tunnel and double row anchor in the treatment of humerus greater tuberosity fracture

doi:10.11958/20221971

Abstract

Abstract:

Objective To investigate the clinical effect of single row anchor (SRA) combined with bone tunnel (SRA-BT) and double row anchor (DRA) in the treatment of greater tuberosity fracture (GTF) of humerus. Methods The medical records of 40 patients with GTF treated with anchor fixation technique were retrospectively analyzed. Patients were divided into the SRA-BT group (18 cases) and the DRA group (22 cases) by surgical methods after doctor-patient communication. The suture bridge technique of SRA combined with bone tunnel was used in the SRA-BT group, and DRA with suture bridge was used in the DRA group. The perioperative and postoperative indicators, complications and postoperative displacement distance of the greater tuberosity were compared between the two groups. The pain degree, functional status and range of motion were assessed 6 months after surgery. Results Bone healing was achieved in all patients without infection or internal fixation failure. There were no significant differences in operative time, intraoperative blood loss, hospital stay, postoperative complications, bone healing time and postoperative displacement distance of the greater tuberosity between the two groups (P>0.05). The incision length was larger in the SRA-BT group than that of the DRA group (P<0.05). The in-patients costs was significantly lower in the SRA-BT group than that of the DRA group (P<0.05). There were no significant differences in postoperative complications between the two groups (P>0.05). The VAS score and ASES score at rest and activity were significantly improved after operation in both groups (P<0.05), but there were no significant differences in VAS score, ASES score and ranges of motion in flexion, abduction, 0°external rotation and 90° internal rotation at rest and activity after operation between the two groups (P>0.05). Conclusion The clinical effect of technology of SRA-BT and DRA have clear clinical efficacy in the treatment of GTF, and both of them could effectively improve shoulder joint function and relieve postoperative pain. However, the SRA-BT has more advantages in reducing medical costs.

Key words: humerus, greater tuberosity fractures, single row anchor, double row anchor, bone tunnel, suture bridge

CLC Number:

R683

Figures/Tables 6

References 25

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组别			n	年龄/岁			受伤至手术时间/d			性别
组别			n	年龄/岁			受伤至手术时间/d			男			女
DRA组			22	66.32±7.66			3.13±1.36			13（59.1）			9（40.9）
SRA-BT组			18	64.17±6.34			2.94±1.16			10（55.6）			8（44.4）
t或χ²				0.953			0.469			0.050
组别	术前肱骨大结节位移距离/mm					侧别					Mutch分型
组别	术前肱骨大结节位移距离/mm					左侧		右侧			撕脱型			劈裂型
DRA组	11.35±2.76					10（45.5）		12（55.6）			18（81.8）			4（18.2）
SRA-BT组	11.58±2.63					7（38.9）		11（61.1）			14（77.8）			4（22.2）
t或χ²	0.268					0.170					0.100
组别		肩关节脱位			致伤原因
组别		肩关节脱位			交通性损伤				运动性损伤			跌倒性损伤
DRA组		7（31.8）			13（59.1）				3（13.6）			6（27.3）
SRA-BT组		6（33.3）			10（55.5）				3（16.7）			5（27.8）
χ²		0.010			0.080

组别			n	年龄/岁			受伤至手术时间/d			性别
组别			n	年龄/岁			受伤至手术时间/d			男			女
DRA组			22	66.32±7.66			3.13±1.36			13（59.1）			9（40.9）
SRA-BT组			18	64.17±6.34			2.94±1.16			10（55.6）			8（44.4）
t或χ²				0.953			0.469			0.050
组别	术前肱骨大结节位移距离/mm					侧别					Mutch分型
组别	术前肱骨大结节位移距离/mm					左侧		右侧			撕脱型			劈裂型
DRA组	11.35±2.76					10（45.5）		12（55.6）			18（81.8）			4（18.2）
SRA-BT组	11.58±2.63					7（38.9）		11（61.1）			14（77.8）			4（22.2）
t或χ²	0.268					0.170					0.100
组别		肩关节脱位			致伤原因
组别		肩关节脱位			交通性损伤				运动性损伤			跌倒性损伤
DRA组		7（31.8）			13（59.1）				3（13.6）			6（27.3）
SRA-BT组		6（33.3）			10（55.5）				3（16.7）			5（27.8）
χ²		0.010			0.080

组别	n	切口长度/cm	手术时间/min	术中出血量/mL	住院时间/d	住院总费用/万元	骨折愈合时间/周	术后肱骨大结节位移距离/mm	术后恢复日常生活时间/d
DRA组	22	5.02±1.07	52.50±13.00	57.77±18.28	10.18±2.70	3.51±0.17	10.85±1.28	3.12±1.05	88.05±16.93
SRA-BT组	18	5.92±1.14	58.39±10.17	66.56±17.17	9.11±2.54	2.10±0.20	10.13±1.42	2.93±1.18	83.50±9.57
t		2.570^＊	1.568	1.554	1.280	24.165^＊＊	1.685	0.539	1.069

组别	n	切口长度/cm	手术时间/min	术中出血量/mL	住院时间/d	住院总费用/万元	骨折愈合时间/周	术后肱骨大结节位移距离/mm	术后恢复日常生活时间/d
DRA组	22	5.02±1.07	52.50±13.00	57.77±18.28	10.18±2.70	3.51±0.17	10.85±1.28	3.12±1.05	88.05±16.93
SRA-BT组	18	5.92±1.14	58.39±10.17	66.56±17.17	9.11±2.54	2.10±0.20	10.13±1.42	2.93±1.18	83.50±9.57
t		2.570^＊	1.568	1.554	1.280	24.165^＊＊	1.685	0.539	1.069

组别	n	静息VAS			活动VAS			ASES
组别	n	术前	术后	t	术前	术后	t	术前	术后	t
DRA组	22	7.72±1.64	1.59±0.67	16.230^＊＊	8.50±1.37	2.41±0.73	18.401^＊＊	23.86±9.63	77.95±9.84	18.427^＊＊
SRA-BT组	18	7.28±1.41	1.27±0.67	16.334^＊＊	8.39±1.33	2.22±0.65	17.683^＊＊	24.72±7.95	80.56±8.20	20.743^＊＊
t		0.898	1.503		0.256	0.860		0.303	0.898