Abstract:

BACKGROUND: More and more patients who have crushing and serious shift proximal humeral fractures that cannot be reconstructed need artificial humeral head replacement. However, the rotator cuff reconstruction may directly affect surgical effect. Thus, better rotator cuff reconstruction is needed during replacement.
OBJECTIVE: To investigate application value of sternum needles in rotator cuff reconstruction of proximal humeral fractures during artificial humeral head replacement.
METHODS: Thirty-four cases of four-part proximal humeral fractures received rotator cuff repairing with sternum needles during artificial humeral head replacement, at the age between 67 and 78 years. Artificial humeral head replacement was performed without excessive peeling fracture block or rotator cuff tissue to retain the rotator cuff tissue and bone connected, and then the sternum needle was used to ringclosure the nodules along the surface of the rotator cuff tendon-bone junction for reverse, sternum needle could be used more than one. After prosthesis implantation, anatomic reduction of the large and small nodules of humerus and bone fragments was performed, and then the sternum needle was tightened; the large and small nodules and rotator cuff attached bone fragments were affixed to the bottom of the humeral head in situ. Operation should maximally suture the residual rotator cuff and damaged muscle tissue, and should pay attention to the dynamic equilibrium after suture. The recovery of artificial shoulder joint function was evaluated with Neer criteria.
RESULTS AND CONCLUSION: All the patients were followed-up for 1-3 years, and the results showed excellent in 24 cases, good in 10 cases and average in two cases. No joint dislocation, subluxation and joint instability, and no infections, nerve injury or prosthesis loosening were observed. Sternum needles for the repairing of rotator cuff and fixation of large and small nodules during artificial humeral head replacement can make the rotator cuff and large and small nodules close to the anatomical location, and the sternum needle has higher strength than conventional polyester line with stable fixation, which can meet the requirement of rehabilitation training after artificial humeral head replacement and play an important role in the recovery of stability and function of the shoulder joint.