Clinical Research Of Rotator Cuff Reconstruction In Proximal Humeral Fractures Which Need Hemiatrhroplasty

Objective To introduce a method which can reconstruct rotator cuff of proximalhumeral fractures which need hemiarthroplastyMethods The clinical data was analyzed retrospectively, from34patients who needhemiarthroplasty between September2005and September2010. There were19malesand15females, between the ages of67to78years old (mean,71.1years). Among these34cases four-part proximal humeral fractures, there were11cases of Part fourdisplacement of fracture,17cases of Part four fracture dislocation and10cases of Jointfracture surface sag area of more than40%. Preoperative Harris score of （22.3±4.8）points.34cases of four-part proximal humeral fractures when humeral head replacementin rotator cuff repair using sternal needle.Operation without excessive peeling fractureblock and rotator cuff tissue, to retain the rotator cuff tissue and bone connected to thesternum needle the size of nodules along the surface of the rotator cuff tendon-bonejunction ring closure reserve, available over the root, Physiological saline wash pulpcavity repeatedly, putting into medullary cavity plug and fixed with bone cement.afterprosthesis implantation, the humeral large and small nodules and minor fragmentsanatomical reduction, tighten the sternum needle, the size of nodules rotator cuff minorfragments were attached to the humeral head in situ attached to the bottom. Operationshould be as much as possible residual rotator cuff and damage in muscle tissue suturerepair, and pay attention to the dynamic equilibrium after suture. Results Postoperative34cases had been followed up, an average time of follow-upwas(23.8±6.6)months. Result:①.the pain:5cases of mild pain,27cases of full of pain,one case of Humeral prosthesis lien is too long to lift on shoulder joint pain, stillpain,and one case of shoulder joint limited movement, pain.②range of movement:34patients who need hemiarthroplasty. Outreach45°to140°,an average of(106.3°±24.8°)；0ut5°to30°, an average of (21.4°±7.6°);Spin within5°to50°, anaverage of(31.3°±10.9°)③function:34patients were all can finish daily lifemovements, such as combing their hair, dress and touch back, etc.④X-ray display: Nolooseness, dislocation, and complications of prosthesis happens during Follow-upperiod,1case of greater tuberosity was higher than artificial humeral head prosthesis.The artificial shoulder joint function Neer criteria to evaluate the recovery of this groupof patients was excellent in7cases,3were good. No joint dislocation, joint instabilitysubluxation and other conditions. No one case of infection, nerve injury and prosthesisloosening. After surgery the patient’s Neer score of (88.9±5.1)points, compared with thepreoperative statistical significance was found between（t=-146.363,P<0.05）Conclusion As technology maturity and hemiarthroplasty clinical application, acceptinghemiarthroplasty patients of proximal humeral fractures will more and more, for suchpatients, the reconstruction of the rotator cuff check point must be as close as possible toanatomic reduction, firmly reconstruction of large and small nodules is the key to therecovery of shoulder joint function. sternum needle and size of nodules of rotator cuff repairrotator cuff and the size of the fixed nodes can close anatomic position, and compared withconventional polyester thread, high strength and rigid fixation meet the needs of thepostoperative rehabilitation training. Sternum needles play an important role in rotator cuffreconstruction.