Abstract
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.
Highlights
Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair
There were no significant differences between groups concerning Bone mineral density (BMD), morphology, and age (n.s.)
In the Single Row (SR) group the mean number of cycles to failure were 10,782 ± 4203 whereas construct failure could be observed in the double row (DR) group at 14317 ±4450 cycles in average
Summary
Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Due to the limited dimension of the subacromial space even small residual superior displacement may cause clinical impairment [2, 9] It has been shown, that conservative treatment for dislocated greater tuberosity fractures is associated with pain and impaired range of motion (ROM) [8]. Seppel et al BMC Musculoskeletal Disorders (2017) 18:506 superior rotator cuff (M. infraspinatus (ISP) and M. supraspinatus (SSP)) forces on the stability of greater tuberosity fractures that were treated arthroscopically using suture anchor techniques. To the knowledge of the authors, there is no biomechanical data comparing single vs double-row anchor fixation. A biomechanical human cadaveric in vitro model was established, that incorporated forces of the postero-superior rotator cuff on the greater tuberosity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
