Department of Orthopaedic Surgery, The 2nd Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shanxi, 710004, China.
Am J Sports Med. 2011 Sep;39(9):1923-8. doi: 10.1177/0363546511408873. Epub 2011 Jun 17.
Traditionally, open reduction and internal fixation is an acceptable choice for treating displaced glenoid articular fracture. Considering some major complications associated with open surgery, however, surgeons have explored a less invasive way to achieve fixation.
This investigation was undertaken to evaluate the clinical results of arthroscopic-assisted reduction and percutaneous cannulated screw fixation for the treatment of Ideberg type III glenoid fractures.
Case series; Level of evidence, 4.
Twenty-three consecutive patients with Ideberg type III glenoid fractures underwent arthroscopic-assisted reduction and percutaneous cannulated screw fixation. Eighteen patients (78.3%) were available for the final follow-up, at a mean of 37.6 months (range, 24-61 months). There were 12 men and 6 women, with an average age of 41.2 years (range, 22-62 years). Dominant sides were involved in 10 patients. The mean time from injury to surgery was 5.9 ± 2.7 days.
The average ranges of motion of the affected shoulders at the final follow-up were 162.8° ± 8.3° in forward elevation, 67.2° ± 4.6° in external rotation at the side, and T8 ± 2 in internal rotation. The average visual analog scale pain score was 0.7 ± 0.9 (range, 0-3), the average American Shoulder and Elbow Surgeons score was 96.0 ± 5.4 (range, 80-100), the average Constant-Murley score was 96.8 ± 2.9 (range, 90-100), and the average University of California, Los Angeles, score was 34.3 ± 0.9 (range, 33-35). No hardware failure or redisplacement of the fracture occurred, and all fractures healed without any major complication associated with the surgery.
Arthroscopic-assisted reduction and percutaneous cannulated screw fixation is a safe and effective method for the treatment of Ideberg type III glenoid fractures.
传统上,切开复位内固定是治疗移位的关节盂骨折的可接受选择。然而,考虑到与开放性手术相关的一些主要并发症,外科医生已经探索了一种侵入性较小的方法来实现固定。
本研究旨在评估关节镜辅助复位和经皮空心螺钉固定治疗 Ideberg Ⅲ型关节盂骨折的临床结果。
病例系列;证据水平,4 级。
23 例 Ideberg Ⅲ型关节盂骨折患者接受关节镜辅助复位和经皮空心螺钉固定。18 例(78.3%)患者获得最终随访,平均随访 37.6 个月(范围,24-61 个月)。其中男 12 例,女 6 例,平均年龄 41.2 岁(范围,22-62 岁)。优势侧 10 例。从受伤到手术的平均时间为 5.9±2.7 天。
最终随访时,受累肩关节的平均活动范围为前屈 162.8°±8.3°,外展 67.2°±4.6°,内旋 T8±2。平均视觉模拟评分疼痛评分为 0.7±0.9(范围,0-3),美国肩肘外科评分平均为 96.0±5.4(范围,80-100),Constant-Murley 评分平均为 96.8±2.9(范围,90-100),加州大学洛杉矶分校评分平均为 34.3±0.9(范围,33-35)。无内固定失败或骨折再移位,所有骨折均愈合,无与手术相关的重大并发症。
关节镜辅助复位和经皮空心螺钉固定是治疗 Ideberg Ⅲ型关节盂骨折的安全有效方法。