Curative effects of Nice knot fixation on tuberosity healing in hemiarthroplasty for complex proximal humeral fractures
10.3760/cma.j.cn115530-20210927-00425
- VernacularTitle:肱骨近端骨折半肩关节置换术中应用Nice结对结节愈合的疗效分析
- Author:
Mingtai MA
1
;
Songlu ZENG
;
Jiabao JU
;
Yichong ZHANG
;
Jianhai CHEN
;
Dianying ZHANG
;
Zhongguo FU
Author Information
1. 北京大学人民医院创伤骨科，创伤救治与神经再生教育部重点实验室，国家创伤医学中心，北京 100044
- Keywords:
Shoulder fractures;
Shoulder dislocation;
Arthroplasty, replacement;
Nice knot
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(2):127-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the curative effects of Nice knot fixation on tuberosity healing in hemiarthroplasty for complex proximal humeral fractures.Methods:A retrospective analysis was conducted of the eligible 32 complex proximal humeral fractures which had been treated at Department of Trauma and Orthopedics, Peking University People's Hospital between May 1, 2016 and May 1, 2019. Nice knot fixation was used to repair greater and lesser tuberosities in hemiarthroplasty for all the patients. There were 6 males and 26 females, aged from 60 to 90 years (mean, 74.9 years). By the Neer classification, there were 4 three-part fractures combined with dislocation, 20 four-part fractures, and 8 four-part fractures combined with dislocation. Shoulder joint X-rays were taken at postoperative 1, 2, 3, 6, and 12 months at the outpatient clinic to evaluate the patients' shoulder joint mobility, visual analog scale (VAS) pain score and Constant-Murley shoulder score. Tuberosity healing was assessed based on the X-rays and related complications were recorded.Results:The 32 patients received complete follow-up for 12 to 25 months (average, 17.82 months). At the 12-month follow-up, their shoulder flexion averaged 131.3° (from 80° to 155°), abduction 126.9° (from 80° to 155°), external rotation 48.4° (from 30° to 60°), internal rotation the L2 level, VAS pain score 0.9 (from 0 to 5), and Constant-Murley score 83.4 (from 58 to 96). The rate of patient satisfaction was 87.5%(28/32). Tuberosity-related complications were observed in 6 cases with an incidence of 18.8%. Complications like infection and prosthetic loosening were found in none of the patients.Conclusion:In hemiarthroplasty for complex proximal humeral fractures, application of Nice knot to fixate greater and lesser tuberosities can lead to rigid fixation, definite curative effects and a low incidence of tuberosity-related complications.
