Combination of Anatomical Plates and Rotator Cuff Reinforcement for Minimally Invasive Treatment of Greater Tuberosity Fractures of the Humerus

Summary

Here, we present a protocol to utilize anatomical plates alongside rotator cuff reinforcement in a minimally invasive surgery to efficiently treat humerus greater tuberosity fractures, promising quicker healing and improved stability.

Abstract

Greater tuberosity fractures of the humerus can be challenging to manage due to their complex anatomy and the potential for compromised shoulder function. We present a novel technique for treating greater tuberosity fractures utilizing specialized anatomical plates and rotator cuff reinforcement. The technique involves the use of an anatomically T-shaped plate designed specifically for the greater tuberosity region of the humerus, allowing for precise fixation and stability. Additionally, rotator cuff reinforcement is performed using sutures to enhance structural integrity and promote early mobilization. The simplified process is as follows: After administering anesthesia, a 3 cm incision is made along the lateral aspect of the shoulder to precisely expose the fracture site of the greater tuberosity. A suture of size 5 is skillfully threaded through the tough rotator cuff tendon to securely attach the proximal humerus to the anatomical plate after the greater tuberosity has been reduced. Intraoperative fluoroscopy is utilized to verify the accurate positioning of plates and screws. After ensuring everything is correct, the surgery concludes.

Introduction

Greater tuberosity fractures of the humerus are a common type of upper limb fracture, often accompanied by joint pain and functional impairment¹. Traditional treatment methods are associated with larger incisions and longer recovery periods.We introduce a refined treatment protocol that maximizes patient outcomes and minimizes surgical invasiveness. Stemming from a growing need for efficient fracture management, this technique's rationale is grounded in the principle of expedited patient recovery with minimal postoperative complications. In recent years, the development of minimally invasive techniques has garnered attention

Protocol

Written informed consent was obtained from the patients for publication. This surgical protocol adheres to the ethical standards established by our institution's human research ethics committee.

1. Preoperative preparation and anesthetic assessment

1. Preoperative preparation
   1. Prior to the surgery, ensure thorough communication with the patient. Explain the purpose, method, risks, and expected outcomes of the surgery.
   2. Obtain written informed .......

Discussion

The incorporation of specialized anatomical plates coupled with rotator cuff reinforcement has revolutionized the management of greater tuberosity humerus fractures, offering a minimally invasive alternative that promulgates improved healing and functionality^6,7,8. Critical steps in this innovative procedure include precise preoperative imaging to evaluate the fracture pattern, careful incision placement to minimize tissue damag.......

Materials

Name	Company	Catalog Number	Comments
Anesthesia monitor	Drager	USRN-0094	N/A
C-arm	GE	B3SS1700060	Intraoperative fluoroscopy
ETHIBOND Excel polyester suture size 5	Johnson&johnson	130705031046294	N/A
Fentanyl citrate injection	Renfu Pharmaceutical	31D090113	anesthesia drugs
Injection of Remifentanil Hydrochloride	Renfu Pharmaceutical	30A11011	anesthesia drugs
Marker pen	Deli Group Co., Ltd.	6921734968258	N/A
Needle deriver	Shanghai Medical Devices Co., Ltd. Surgical Instrument Factory	J32100	N/A
Patient monitor	Drager	SQC19090042HA	N/A
Povidone-iodine	Hangzhou Minsheng Pharmaceutical Co., Ltd.	532310292	antiseptic solution
Propofol emulsion injection	Xi'an Libang Pharmaceutical Co., Ltd.	12312072I	anesthesia drugs
Proximal humerus locking compression plate(T)	WEGO	MB66G	It is used for avulision fracture of the greater tuberosity of humerus.
Rocuronium bromide injection	Emeishan Tonghui Pharmaceutical Co., Ltd.	23112001	anesthesia drugs
Surgical blade	Hangzhou Huawei Medical Supplies Co., Ltd.	20152020713	N/A