ROTATOR CUFF TEAR REPAIR DURING INTERNAL FIXATION OF ACCOMPANIED PROXIMAL HUMERUS FRACTURES AND CLINICAL OUTCOMES

Abstract

Purpose of the Study: We evaluated the results of surgical treatment for rotator cuff tears accompanied by proximal humerus fractures.

Materials and Methods: Between September 2005 and April 2009, among a total of 103 patients undergoing surgical treatment with internal fixation for humerus fracture, 7 patients (6 females, 1 male; mean age 72.4 years; range 56 to 84years) underwent surgical treatment for rotator cuff tears accompanied by proximal humerus fracture. The mean follow-up period was 14 months (range 5 to 24 months). Radiographically, all fractures were classified according to the AO/ASIF system. AO/ASIF system type 11A2 accompanied by 12C2 (n:1), 11B1 (n:2), 11B2 (n:2), 11C2 (n:2). MRI was not used in any of the cases. All rotator cuff tears were determinated during the operation. Rotator cuff tears were repaired by primary suture (n:2), suture anchor (n:5), using the deltoid split approach (after treatment of proximal humerus fracture with open reduction and internal fixation. All patients used shoulder-arm sling for 6 weeks. Standard fracture rehabilitation was performed. Functional and radiographic results were evaluated.

Results: None of the patients developed nonunion, implant failure or avascular necrosis. In the final evaluation, the Constant shoulder score was 82.8 (50–100). All patients were satisfied with results.

Conclusion: The presence of rotator cuff tears in fractures of the proximal humerus is a especially possible in the elderly. Simultaneous repair of the fracture and rotator cuff does not create a negative functional and radiologic effect and prevents a future functional loss. Therefore the investigation of rotator cuff tears in all proximal humerus fractures and when present, treatment in the same session will increase the success of functional results.