Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures
Background: The importance of tuberosity healing in reverse total shoulder arthroplasty for proximal humeral fractures (PHFs) has been recognized. The turned stem tension band (TSTB) technique has been applied to tuberosity repair, and high bone healing and low reduction loss rates have been reporte...
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2025-01-01
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| author | Kazumasa Takayama, MD Hiromu Ito, MD, PhD |
| author_facet | Kazumasa Takayama, MD Hiromu Ito, MD, PhD |
| author_sort | Kazumasa Takayama, MD |
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| description | Background: The importance of tuberosity healing in reverse total shoulder arthroplasty for proximal humeral fractures (PHFs) has been recognized. The turned stem tension band (TSTB) technique has been applied to tuberosity repair, and high bone healing and low reduction loss rates have been reported. Vertical sutures were added to the original method to reinforce fixation. We hypothesized that vertical sutures would be unnecessary in case the supraspinatus tendon was resected. This study aimed to compare the TSTB technique with or without vertical suturing for PHFs and evaluate the rates of tuberosity healing and reduction loss. Methods: Thirty five patients (vertical suture group: 18 cases and nonvertical suture group: 17 cases) underwent reverse total shoulder arthroplasty for complex PHFs using the TSTB technique. We evaluated the postoperative range of motion, the American Shoulder and Elbow Surgeons score, tuberosity healing rates, and reduction loss. Results: The vertical and nonvertical suture groups showed no significant difference in flexion (119 ± 33° vs. 124 ± 23°, P = .95), abduction (116 ± 35° vs. 115 ± 27°, P = .78), external rotation (27 ± 12° vs. 21 ± 8°, P = .16), internal rotation (6 ± 4° lumbar 3 level vs. 6 ± 4°, lumbar 3 level P = .87), the American Shoulder and Elbow Surgeons (77.3 ± 10.7 vs. 81.6 ± 6.3, P = .59), Numerical Rating Scale scores (1.2 ± 0.9 vs. 0.8 ± 0.9, P = .13), and tuberosity reduction loss (P = .34). The tuberosity healing rate in both groups was 100%. Conclusion: The TSTB technique for PHFs provided high tuberosity healing and low reduction loss rates regardless of vertical sutures. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | JSES International |
| spelling | doaj-art-8c03c283a02a4fe799e945d0b4746ab12025-01-12T05:25:57ZengElsevierJSES International2666-63832025-01-0191155162Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical suturesKazumasa Takayama, MD0Hiromu Ito, MD, PhD1Corresponding author: Kazumasa Takayama, MD, Department of Orthopaedics, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan.; Department of Orthopaedics, Kurashiki Central Hospital, Kurashiki, Okayama, JapanDepartment of Orthopaedics, Kurashiki Central Hospital, Kurashiki, Okayama, JapanBackground: The importance of tuberosity healing in reverse total shoulder arthroplasty for proximal humeral fractures (PHFs) has been recognized. The turned stem tension band (TSTB) technique has been applied to tuberosity repair, and high bone healing and low reduction loss rates have been reported. Vertical sutures were added to the original method to reinforce fixation. We hypothesized that vertical sutures would be unnecessary in case the supraspinatus tendon was resected. This study aimed to compare the TSTB technique with or without vertical suturing for PHFs and evaluate the rates of tuberosity healing and reduction loss. Methods: Thirty five patients (vertical suture group: 18 cases and nonvertical suture group: 17 cases) underwent reverse total shoulder arthroplasty for complex PHFs using the TSTB technique. We evaluated the postoperative range of motion, the American Shoulder and Elbow Surgeons score, tuberosity healing rates, and reduction loss. Results: The vertical and nonvertical suture groups showed no significant difference in flexion (119 ± 33° vs. 124 ± 23°, P = .95), abduction (116 ± 35° vs. 115 ± 27°, P = .78), external rotation (27 ± 12° vs. 21 ± 8°, P = .16), internal rotation (6 ± 4° lumbar 3 level vs. 6 ± 4°, lumbar 3 level P = .87), the American Shoulder and Elbow Surgeons (77.3 ± 10.7 vs. 81.6 ± 6.3, P = .59), Numerical Rating Scale scores (1.2 ± 0.9 vs. 0.8 ± 0.9, P = .13), and tuberosity reduction loss (P = .34). The tuberosity healing rate in both groups was 100%. Conclusion: The TSTB technique for PHFs provided high tuberosity healing and low reduction loss rates regardless of vertical sutures.http://www.sciencedirect.com/science/article/pii/S2666638324003785Turned stem tension band techniqueProximal humeral fractureTuberosityTension bandReverse shoulderBone resorption |
| spellingShingle | Kazumasa Takayama, MD Hiromu Ito, MD, PhD Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures JSES International Turned stem tension band technique Proximal humeral fracture Tuberosity Tension band Reverse shoulder Bone resorption |
| title | Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| title_full | Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| title_fullStr | Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| title_full_unstemmed | Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| title_short | Turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| title_sort | turned stem tension band technique in reverse total shoulder arthroplasty for proximal humeral fracture can achieve high tuberosity healing rates regardless of the vertical sutures |
| topic | Turned stem tension band technique Proximal humeral fracture Tuberosity Tension band Reverse shoulder Bone resorption |
| url | http://www.sciencedirect.com/science/article/pii/S2666638324003785 |
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