■这项研究调查了接受反向肩关节成形术(RSA)并伴随锁骨远端切除术(DCE)的患者肩峰功能不全骨折(AIF)的发生率。
■确定了2010年至2021年由一名外科医生使用DCE进行原发性RSA的患者。排除标准包括修订RSA,RSA用于骨折,或使用增强底板或骨移植物的病例。AIF被定义为影像学证实的肩峰或肩胛骨骨折。影像学上没有可识别骨折的疼痛被定义为肩峰功能不全反应。患者人口统计学,植入信息,比较有无肩峰病理的患者的X线片测量结果。
■纳入了一百七十五名患者。平均年龄72.8岁,67%的患者为女性。有3/174肩峰功能不全骨折(1.7%)。AIF平均发生在术后9.3个月。12例患者出现功能不全反应(6.9%)。肩峰病理患者更可能是女性(p=.003),并且诊断为骨质疏松症(p=.047)和炎性关节炎(p=.049)。在其他因素方面,组间无显著差异。
■接受DCE的RSA患者的AIF率为1.7%。这些发现表明,RSA设置中的DCE可能对AIF具有保护作用。
UNASSIGNED: This study investigated the rate of acromial insufficiency fractures (AIF) in patients undergoing reverse shoulder arthroplasty (RSA) with concomitant distal clavicle excision (DCE).
UNASSIGNED: Patients who underwent primary RSA with DCE by a single surgeon from 2010 to 2021 were identified. Exclusion criteria included revision RSA, RSA for fracture, or cases utilizing an augmented baseplate or bone graft. AIF was defined as a radiographically proven acromion or scapular spine fracture. Pain without an identifiable fracture on imaging was defined as an acromial insufficiency reaction. Patient demographics, implant information, and radiograph measurements were compared between patients with and without acromial pathology.
UNASSIGNED: One hundred and seventy-five patients were included. Mean age was 72.8 years, and 67% of patients were female. There were 3/174 acromial insufficiency fractures (1.7%). AIF occurred at a mean of 9.3 months after surgery. Twelve patients had insufficiency reactions (6.9%). Patients with acromial pathology were more likely to be female (p = .003) and have a diagnosis of osteoporosis (p = .047) and inflammatory arthritis (p = .049). There was no significant difference between groups in terms of other factors.
UNASSIGNED: The AIF rate in patients who underwent RSA with DCE was 1.7%. These findings suggest that DCE in the setting of RSA may have a protective role against AIF.