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Archives of Orthopaedic and Trauma Surgery

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01-05-2010 | Trauma Surgery

Microcirculatory sequelae of the rotator cuff after antegrade nailing in proximal humerus fracture

Authors: Philip Gierer, Martin Scholz, Markus Beck, Klaus D. Schaser, Brigitte Vollmar, Thomas Mittlmeier, Georg Gradl

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2010

Abstract

Introduction

Antegrade nailing allows a stable fixation and, thus, an early functional after treatment in proximal humerus fractures. Since the surgical procedure in antegrade humeral nailing requires a split of the supraspinatus tendon, the question arises whether the surgical approach causes microcirculatory dysfunction of the tendon.

Materials and methods

A total of 15 consecutive patients suffering from proximal humerus fractures were enrolled. During the implantation of an antegrade humerus nail, microvascular perfusion of the supraspinatus tendon was directly visualized after the exposition and stabilization of the fracture using the OPS-imaging technique.

Results

Immediately after exposure, the nutritive perfusion showed physiological values of tendon microcirculation. After implanting antegrade humeral nails, the perfusion of the supraspinatus tendon reduced markedly. Capillary width was unaffected by the surgical procedure.

Conclusion

The trauma leading to proximal humerus fracture causes no fundamental impairment of nutritive perfusion of the rotator cuff. Whereas the implantation of an antegrade humerus nail, which necessarily includes a splitting of the rotator cuff, nearly halves the functional capillary density of the supraspinatus tendon. Even though this effect seems to be reversible, the surgical dissection of the supraspinatus tendon should be performed in a soft tissue sparing way.

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Title: Microcirculatory sequelae of the rotator cuff after antegrade nailing in proximal humerus fracture
Authors: Philip Gierer
Martin Scholz
Markus Beck
Klaus D. Schaser
Brigitte Vollmar
Thomas Mittlmeier
Georg Gradl
Publication date: 01-05-2010
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-009-0956-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Microcirculatory sequelae of the rotator cuff after antegrade nailing in proximal humerus fracture

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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