Paper # 24: Arthroscopic Treatment of Anterior Shoulder Dislocation with Displaced Greater Tuberosity Fracture

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ABSTRACTS

(10-22) weeks. Anterior capsulolabral repair was achieved using biofastak anchors in 20 patients, and knotless anchors in 32 patients. The outcomes were compared with Rowe, DASH and Constant scores and subjective self assessment of the patients preoperatively, by 6th and 12th postoperative weeks and at the end of a mean follow-up time of 36.1 (14-91) months. MannWhitney U and Wilcoxon tests were used in statistical analysis. The p values under 0.05 were considered as significant. Results: The mean time to return to pre-instability activity level was 15.4 weeks in first-time dislocation group and 17.4 weeks in multiple dislocations group. At the end of the 6 postoperative weeks the median Rowe, DASH and Constant scores of the first-time dislocation group (80 (65-90), 12.9 (4.17-21.7) and 89.5 (65-98.8)) were significantly better than those of multiple dislocations group (70 (50-100), 20.4 (5.8-52.5)) and 70 (53-99) (p ⬍ 0.001). At the end of a mean follow-up time of 36.1 months, while the outcome scores of the first-time dislocation group was better, there was no statistically significant difference between the groups (p⫽0.28; p⫽0.24; p⫽0.41, for Rowe, DASH and Constant scores, respectively). No patient had recurrent instability in the firsttime dislocation group, while one had traumatic dislocation in multiple dislocations group. Conclusion: Our results suggested that artroscopic capsulolabral repair can yield better functional results in the early postoperative period in patients with first-time dislocation. However the functional results at the last control did not reveal any significant advantage of either timing. Paper # 24: Arthroscopic Treatment of Anterior Shoulder Dislocation with Displaced Greater Tuberosity Fracture RICKSON MORAES, MD, BRAZIL BRUNO LOBO BRANDÃO, MD, BRAZIL MARIO PACHECO, MD, BRAZIL MARCIO COHEN, BRAZIL MARCUS VINICIUS GALVÃO AMARAL, MD, BRAZIL MARTIM MONTEIRO, BRAZIL GERALDO ROCHA MOTTA FILHO, MD, BRAZIL · INTO Rio de Janeiro, BRAZIL Summary: Suture bridge is a feasible technique for arthroscopic treatment of anterior shoulder dislocation with displaced greater tuberosity fracture, also permitting appropriate diagnosis and treatment of associated lesions. Abstract: Purpose: The purpose of this study was to evaluate the

results of arthroscopic treatment of anterior shoulder dislocation with a displaced greater tuberosity fracture. Methods: Five patients were included, with a mean age of 42 years (20 to 59) and mean follow-up of 14 months. The arthoscopic procedure was performed in standard fashion, in the beach chair position. Two patients showed a Bankart lesion and one had a type III SLAP lesion. Fixation of the greater tuberosity fragment was performed with a suture bridge technique. Depending on the size of the bone fragment, one or two bioabsorbable anchors were inserted on the medial aspect of the fracture site on the humeral head, close to the anatomical neck. The sutures were passed through the transition of the rotator cuff and bone, with execution of a mattress stitch. These sutures were then passed over the greater tuberosity fragment and fixed laterally with a bioabsorbable interference screw. The Bankart lesions were fixed with bioabsorbable anchors and the SLAP lesion was treated with bucket handle resection. Clinical assessment was performed using the UCLA, Constant, and Rowe scores, as well as measurement of active range of motion (ROM). Radiographs were performed to evaluate displacement and healing of the greater tuberosity. Results: The fractures healed without displacement in all the cases. Everyone was satisfied with the procedure. The mean active ROM was: elevation 170°⫾ 6°, external rotation 70°⫾ 10°, and internal rotation T8. Mean scores were: UCLA 34⫾ 1, Constant 94⫾ 5, and Rowe 96⫾ 4. None of the patients had instability symptoms and there were no complications. Conclusion: Arthroscopic fixation is a feasible and effective option for treatment of anterior shoulder dislocation with a displaced greater tuberosity fracture, also permitting appropriate diagnosis and treatment of intraarticular associated lesions.

Paper # 25: Single-Row Rotator Cuff Repair Using a Modified Suture Configuration versus a SutureBridging Double-Row Repair - Comparable Biomechanical Results and Complete Footprint Coverage Independent of the Initial Tear Size OLAF LORBACH, MD, GERMANY DIETRICH PAPE, MD, PHD, LUXEMBOURG FLORIAN RABER, MD, GERMANY DIETER KOHN, MD, PHD, GERMANY MATTHIAS KIEB, MD, GERMANY · Saarland University, Dep. of Orthopedic Surgery Homburg (Saar), GERMANY