Effectiveness of rotator cuff repair surgery in treating proximal humeral fractures and its association with patient age and Neer classification
10.3760/cma.j.cn341190-20231025-00333
- VernacularTitle:肩袖修补术治疗肱骨近端骨折的疗效与年龄、Neer分型的相关性分析
- Author:
Hao YUAN
1
;
Yonggang CHENG
;
Zhizhong CAI
Author Information
1. 武警海警总队医院骨外科，嘉兴 314000
- Keywords:
Humeral fractures;
Surgical procedures, operative;
Shoulder joint;
Hemorrhage;
Fracture healing;
Age factors;
Postoperative complications
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(5):668-674
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness of rotator cuff repair surgery in treating proximal humeral fractures and its association with patient age and Neer classification.Methods:A retrospective analysis was conducted on the clinical data of 90 patients with proximal humeral fractures who underwent rotator cuff repair surgery at the Marine Police Corps Hospital of the Chinese People's Armed Police Force between January 2020 and January 2023. The clinical data of these patients were retrieved from the hospital's medical record database. Based on the age distribution of the patients, they were divided into four groups: Group 1 (> 18 years old and < 30 years old, n = 10), Group 2 (≥ 30 years old and < 45 years old, n = 15), Group 3 (≥ 45 years old and < 60 years old, n = 40), and Group 4 (> 60 years old, n = 25). There were no statistically significant differences in baseline data among the four groups (all P > 0.05), indicating comparability. Additionally, these patients were divided into three groups based on Neer classification: Group I (Neer type II, n = 28), Group II (Neer type III, n = 30), and Group III (Neer type IV, n = 32). Differences in various outcome measures related to treatment efficacy, including operation time, intraoperative blood loss, fracture healing time, Visual Analogue Scale (VAS) score, Constant-Murley score, Neer shoulder function score, and the overall incidence of postoperative complications, were recorded and compared across different age groups. Overall efficacy was assessed according to the Neer criteria: > 90 points as excellent, 80-89 as good, 70-79 as fair, and < 70 as poor. Results:After 6 months of surgery, the overall clinical treatment effectiveness rate was 95.56% (86/90). At 2 weeks postoperatively, the VAS score was (3.45 ± 1.35) points, which was significantly decreased compared with the level measured preoperatively ( P < 0.05). At 6 months postoperatively, the Constant-Murley score and Neer shoulder function score were (90.34 ± 6.34) points and (86.34 ± 5.46) points, respectively (both P < 0.05), which were significantly increased compared with the levels measured preoperatively. There were significant differences in fracture healing time ( F = 4.89, P < 0.05), intraoperative blood loss ( F = 5.28, P < 0.05), VAS score ( F = 5.02, P < 0.05), and Neer shoulder function score ( F = 5.32, P < 0.05) and Constant-Murley scores ( F = 3.85, P < 0.05) compared with before treatment. There was no statistically significant difference in the overall incidence of postoperative complications or surgical time among Groups 1, 2, 3,and 4 [0 vs. 5.00% (2/40) vs. 6.67% (1/15) vs. 12.00% (3/25), χ2 = 0.98, P > 0.05]. Group III had longer surgical time and fracture healing time compared with Groups I and II ( F = 4.55, 4.23, both P < 0.05), with greater intraoperative blood loss ( F = 5.24, both P < 0.05). Additionally, Group III had a higher VAS score compared with Groups I and II ( F = 5.06, P < 0.05), while the Neer shoulder joint function score and Constant-Murley score in Group III were lower ( F = 3.83, 4.56, both P < 0.05). There was no statistically significant difference in the overall incidence of postoperative complications among the Groups I, II, and III [9.38% (3/32) vs. 3.57% (1/28) vs. 6.67% (2/30), χ2 = 1.00, all P > 0.05]. Pearson correlation analysis revealed a positive correlation between patient age, Neer classification, intraoperative blood loss, fracture healing time, and VAS score ( r = 0.565, all P < 0.05), and a negative correlation with the Neer shoulder joint function score ( r = -0.620, P < 0.05). However, there was no significant correlation between patient age, Neer classification, and the Constant-Murley score ( r = -0.008, P > 0.05). Conclusion:The rotator cuff repair is effective in treating proximal humeral fractures, but the effectiveness varies depending on patient age and Neer classification. Patient age and Neer classification are positively correlated with intraoperative blood loss, fracture healing time, and VAS score, while they are negatively correlated with the Neer shoulder joint function score.
