Single versus double row suture anchor fixation for greater tuberosity fractures – a biomechanical study

BMC Musculoskeletal Disorders

Research Article

Alberto Guevara-Alvarez¹  Andreas B. Imhoff¹  Frank Martetschläger²  Gernot Seppel³  Tim Saier⁴  Johannes E. Plath⁵  Stefan Buchmann⁶  Martin Winkler⁷  Julia Henschel⁷  Peter Augat⁸ 

[1] Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Center for Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany;Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Department of Orthopedics and Trauma Surgery, Krankenhaus Barmherzige Brüder, Munich, Germany;Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Department of Reconstructive Joint Surgery and Sportstraumatology, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany;Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Department of Trauma Surgery, Klinikum Augsburg, Augsburg, Germany;Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany;Orthopädisches Fachzentrum, Weilheim, Germany;Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany;Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany;Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria;

关键词: Greater tuberosity fracture;    Suture anchor;    Arthroscopic;    Double row fixation;    Single-row;   

DOI  :  10.1186/s12891-017-1868-7

 received in 2016-11-30, accepted in 2017-11-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundFractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Yet, no biomechanical study has been performed comparing fixation strength of arthroscopic single- (SR) vs. double row (DR) fixation.MethodsStandardized fractures of the greater tuberosity were created in 12 fresh frozen proximal humeri. After random assignation to the SR or DR group the fixed humeri were tested applying cyclic loading to the supraspinatus and infraspinatus tendon. Load to failure and fragment displacement were assessed by means of an electrodynamic material testing machine using an optical tracking system.ResultsLoad to failure values were higher in the DR group (649 N; ±176) than in the SR group (490 N; ±145) however without statistical significance (p = .12). In greater tuberosity displacement of 3–5 mm surgical treatment is recommended. The fixing constructs in this study did not reach displacement landmarks of 3 or 5 mm before construct failure as shown in previous studies. Thus the applied traction force (N) at 1 mm displacement was analyzed. In the SR group the load at 1 mm displacement was 277 N; ±46 compared to 260 N; ±62 in the DR group (p = .65).ConclusionThe results suggest that both techniques are viable options for refixation of greater tuberosity fractures.Level of Evidence: Laboratory study.

【 授权许可】

CC BY   
© The Author(s). 2017