Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

  • Kim, Se Jin (Department of Orthopedic Surgery, St. Carollo Hospital) ;
  • Lee, Sung Hyun (Institute of Wonkwang Medical Science and Department of Orthopedic Surgery, Wonkwang University Hospital) ;
  • Jung, Dae Woong (Department of Orthopedic Surgery, St. Carollo Hospital) ;
  • Kim, Jeong Woo (Institute of Wonkwang Medical Science and Department of Orthopedic Surgery, Wonkwang University Hospital)
  • Received : 2017.06.05
  • Accepted : 2017.07.30
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. Methods: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. Results: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. Conclusions: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.

Keywords

References

  1. Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg Br. 1984;66(5):725-31. https://doi.org/10.2106/00004623-198466050-00011
  2. Ko SH, Jeon HM, Shin SM. Arthroscopy assisted percutaneous reduction and screw fixation of a displaced intra-articular glenoid fracture: a case report. J Korean Shoulder Elbow Soc. 2010;13(1):127-31. https://doi.org/10.5397/CiSE.2010.13.1.127
  3. Ideberg R, Grevsten S, Larsson S. Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand. 1995;66(5):395-7. https://doi.org/10.3109/17453679508995571
  4. Goss TP. Fractures of the glenoid cavity. J Bone Joint Surg Am. 1992;74(2):299-305. https://doi.org/10.2106/00004623-199274020-00019
  5. Imatani RJ. Fractures of the scapula: a review of 53 fractures. J Trauma. 1975;15(6):473-8. https://doi.org/10.1097/00005373-197506000-00002
  6. Geissler WB, Freeland AE. Arthroscopically assisted reduction of intraarticular distal radial fractures. Clin Orthop Relat Res. 1996;(327):125-34.
  7. Jennings JE. Arthroscopic management of tibial plateau fractures. Arthroscopy. 1985;1(3):160-8. https://doi.org/10.1016/S0749-8063(85)80003-7
  8. Miller MD. Arthroscopically assisted reduction and fixation of an adult Tillaux fracture of the ankle. Arthroscopy. 1997;13(1):117-9. https://doi.org/10.1016/S0749-8063(97)90220-6
  9. McCarthy JJ, Parker RD. Arthroscopic reduction and internal fixation of a displaced intraarticular lateral femoral condyle fracture of the knee. Arthroscopy. 1996;12(2):224-7. https://doi.org/10.1016/S0749-8063(96)90016-X
  10. Carro LP, Nunez MP, Llata JI. Arthroscopic-assisted reduction and percutaneous external fixation of a displaced intra-articular glenoid fracture. Arthroscopy. 1999;15(2):211-4. https://doi.org/10.1053/ar.1999.v15.015021
  11. Gigante A, Marinelli M, Verdenelli A, Lupetti E, Greco F. Arthroscopy-assisted reduction and percutaneous fixation of a multiple glenoid fracture. Knee Surg Sports Traumatol Arthrosc. 2003;11(2):112-5. https://doi.org/10.1007/s00167-002-0340-9
  12. Cameron SE. Arthroscopic reduction and internal fixation of an anterior glenoid fracture. Arthroscopy. 1998;14(7):743-6. https://doi.org/10.1016/S0749-8063(98)70102-1
  13. Marsland D, Ahmed HA. Arthroscopically assisted fixation of glenoid fractures: a cadaver study to show potential applications of percutaneous screw insertion and anatomic risks. J Shoulder Elbow Surg. 2011;20(3):481-90. https://doi.org/10.1016/j.jse.2010.08.003
  14. Tuman JM, Bishop JA, Abrams GD. Arthroscopic reduction and internal fixation of an inferior glenoid fracture with scapular extension (Ideberg V). Arthrosc Tech. 2015;4(6):e869-72. https://doi.org/10.1016/j.eats.2015.08.012