Cow-hitch-suture cerclage for fixation of the greater tuberosity in fracture RTSA

© 2020 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 5(2021), 2 vom: 09. März, Seite 270-276
1. Verfasser: Grubhofer, Florian (VerfasserIn)
Weitere Verfasser: Bachmann, Elias, Gerber, Christian, Wieser, Karl, Ernstbrunner, Lukas, Warner, Jon Jp, Bouaicha, Samy
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2021
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Cadaver study Proximal humerus fracture cow hitch cerclage greater tuberosity fixation technique in vitro stability testing of the greater tuberosity reverse total shoulder arthroplasty
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520 |a BACKGROUND: The treatment of complex proximal humerus fractures in the elderly with reverse total shoulder arthroplasty is an established treatment option. Healing of the greater tuberosity (GT) is associated with better outcomes. It was the aim of this cadaver study to compare the stability of GT refixation obtained with the so-called "cow hitch" cerclage fixation with that of the recommended standard suture cerclage technique 
520 |a METHODS: A 4-part proximal humerus fracture was created in 10 fresh-frozen, human cadaveric shoulders. A CT was performed preoperatively to ensure the comparability of bone density and fracture patterns. In the experimental group the GT was reattached to the stem of the reverse total shoulder arthroplasty with the "cow hitch" suture cerclage (CH) technique, the conventional (CON) technique recommended for the tested implant was used in the control group. Humeri were tested with a uniaxial material testing machine. In total, 5000 loading cycles with forces from 250 to 350N were applied while motion (in mm) of the tuberosities was recorded with a telecentric camera 
520 |a RESULTS: After 5000 loading cycles, the CH group showed a significantly smaller displacement of the bone fragment (0.74 ± 0.31 mm) than the CON group [2.29 ± 1.08 mm (P < .05)]. After the first three cycles the mean displacement was 0.14 mm (±0.12) in the CH and 1.42 mm (±0.21) in the CON (P < .0001) groups 
520 |a CONCLUSIONS: GT reattachment with the "cow hitch" suture cerclage showed a significantly more stable fixation compared with the currently for the used prosthetic system recommended suture cerclage technique in an in vitro 4-part proximal humeral fracture model 
650 4 |a Journal Article 
650 4 |a Cadaver study 
650 4 |a Proximal humerus fracture 
650 4 |a cow hitch cerclage 
650 4 |a greater tuberosity fixation technique 
650 4 |a in vitro stability testing of the greater tuberosity 
650 4 |a reverse total shoulder arthroplasty 
700 1 |a Bachmann, Elias  |e verfasserin  |4 aut 
700 1 |a Gerber, Christian  |e verfasserin  |4 aut 
700 1 |a Wieser, Karl  |e verfasserin  |4 aut 
700 1 |a Ernstbrunner, Lukas  |e verfasserin  |4 aut 
700 1 |a Warner, Jon Jp  |e verfasserin  |4 aut 
700 1 |a Bouaicha, Samy  |e verfasserin  |4 aut 
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