Arthroscopical Findings after Antegrade Nailing of a Proximal Humeral Fracture |
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Authors: | Lars Grossterlinden Peter Ueblacker Johannes M Rueger |
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Institution: | (1) Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;(2) Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany |
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Abstract: | Abstract Proximal humeral fractures represent up to five percent of all fractures in adults, commonly found in elderly patients. The
final functional results after different operative procedures are among other factors dependent on whether or not a rotator
cuff lesion is pre-existent, prior to the fracture, and how its surgical therapy is carried out. However, to what extent prior
rotator cuff tears in this special patient group contribute to the functional outcome remains widely unclear. In our institution
antegrade intramedullary nailing is the treatment of choice for proximal humeral fractures. One critical point of this technique
is the unavoidable split of the rotator cuff on the approach to the proximal humerus and the insertion of the nail through
the incised cuff. We report on a case of an impingement after antegrade intramedullary nailing of a proximal humeral fracture.
Diagnostic glenohumeral arthroscopy revealed neither a residual lesion of the former rotator cuff incision nor a chondral
lesion at the former insertion site of the nail. In the same session subacromial decompression and a nettoyage of adhesions
were performed. We assume that splitting the rotator cuff for the insertion of an antegrade nail in a proximal humeral fracture
is less relevant than previously assumed and described. |
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Keywords: | Arthroscopy Proximal humeral fracture Rotator cuff Antegrade nail Humeral cartilage |
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