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Archives of Orthopaedic and Trauma Surgery

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01-11-2018 | Trauma Surgery

Retaining or excising the supraspinatus tendon in complex proximal humeral fractures treated with reverse prosthesis: a biomechanical analysis in two different designs

Authors: Joan Miquel, F. Santana, E. Palau, M. Vinagre, K. Langohr, A. Casals, C. Torrens

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2018

Abstract

Purpose

We aimed to biomechanically evaluate the effect of the supraspinatus tendon on tuberosity stability using two different reverse shoulder arthroplasty (RSA) models for complex proximal humeral fractures (PHFs).

Methods

Four-part proximal humeral fractures were simulated in 20 cadaveric shoulders. Two different RSA designs were implemented: a glenosphere-medialized model and a glenosphere-lateralized model. Tuberosities were reconstructed, and displacement of bony fragments was measured (mm) by placing three sensors: in the humeral diaphysis (D), in the greater tuberosity (GT), and in the lesser tuberosity (LT). Axial forces were induced and measured in Newton (N). The test was performed twice in each specimen, with and without the supraspinatus tendon. The regression line (RL) was measured in mm/N.

Results

In the medialized model, the GT–D displacement was greater in the supraspinatus preserving model than that in the tendon excision model (p < 0.001), as well as for the LT–D displacement (p < 0.001). In the lateralized model, GT–D displacement and GT–LT distance were greater in the preserving model than that in the excision model (p < 0.001, p = 0.04).

Conclusion

The supraspinatus tendon resection leads to a more biomechanically stable tuberosity construct when performing RSA for PHFs, while the rest of the rotator cuff tendons (infraspinatus and teres minor) are retained in the greater tuberosity.

Level of evidence

Basic science study. Cadaveric study.

Available only for authorised users

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Title: Retaining or excising the supraspinatus tendon in complex proximal humeral fractures treated with reverse prosthesis: a biomechanical analysis in two different designs
Authors: Joan Miquel
F. Santana
E. Palau
M. Vinagre
K. Langohr
A. Casals
C. Torrens
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-3016-8

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Springer Medicine

Retaining or excising the supraspinatus tendon in complex proximal humeral fractures treated with reverse prosthesis: a biomechanical analysis in two different designs

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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