Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
San Antonio Medical Center Orthopedics, San Antonio, Texas, U.S.A.
Arthroscopy. 2019 Aug;35(8):2501-2508.e2. doi: 10.1016/j.arthro.2019.02.047.
To systematically review patient and technical risk factors for anterior glenoid rim fractures through suture anchor points (i.e. "postage stamp") after arthroscopic Bankart repair.
An independent, duplicate search of Embase, Medline, and Web of Science databases, in addition to the past 5-year annual meeting abstracts of several prominent shoulder meetings, was conducted according to R-AMSTAR and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify English-language studies reporting this complication.
A screen of 2,833 studies yielded 6 for inclusion herein. Data across 43 patients, aged 14 to 61 years (mean 24.4), 5% female, and who were followed for 4 to 108 months postoperatively, were reviewed. Only 1 of 6 studies (n = 2) reported postage stamp fracture in female patients. Median time from initial surgery to fracture ranged from 12 to 24 months. Five of 6 studies (n = 32) reported a median age at initial surgery of 25 years or younger (range 17-35). Four of 6 studies (n = 30) reported fracture mostly after sport involvement. All studies (n = 35) reported initial fixation with a median of 3 anchors or more, 3 of 5 studies (n = 26) reported fracture entirely after conventional knot-tying anchors, and 5 of 6 studies (n = 24) reported more fractures after absorbable suture anchor use. Fractures occurred entirely through anchor holes in 5 of 6 studies (n = 29) and mostly after osteolysis in 3 of 4 studies (n = 19). Management strategies after fracture included revision arthroscopic Bankart repair or open Bristow/Latarjet procedures.
Postage stamp fractures were reported frequently in patients who were male, age 25 years or younger, and participants in sporting activities and in fractures initially stabilized with 3 or more anchors or conventional knot-tying anchors or that experienced osteolysis around anchor sites.
Level IV, systematic review of level III and IV studies.
通过关节镜下 Bankart 修复术后经缝线锚钉（即“邮票”）发生的前肩胛盂缘骨折的患者和技术相关风险因素进行系统回顾。
根据 R-AMSTAR 和系统评价和荟萃分析报告的首选项目，对 Embase、Medline 和 Web of Science 数据库进行独立的、重复的搜索，此外还对几家著名肩部会议的过去 5 年年会摘要进行了搜索，以确定报告该并发症的英文研究。
筛选出 2833 项研究，其中 6 项符合纳入标准。对 43 名年龄 14 至 61 岁（平均 24.4 岁）、5%为女性、术后随访 4 至 108 个月的患者的数据进行了回顾。仅有 6 项研究中的 1 项（n=2）报告了女性患者的邮票样骨折。从初次手术到骨折的中位数时间为 12 至 24 个月。6 项研究中的 5 项（n=32）报告初次手术时的中位数年龄为 25 岁或以下（范围 17-35 岁）。6 项研究中的 4 项（n=30）报告骨折主要发生在运动参与后。所有研究（n=35）报告初始固定使用中位数为 3 个或更多的锚钉，5 项研究中的 3 项（n=26）报告完全使用传统结系锚钉固定后发生骨折，6 项研究中的 5 项（n=24）报告使用可吸收缝线锚钉后骨折更多。5 项研究中的 6 项（n=29）的所有骨折均完全通过锚钉孔发生，4 项研究中的 3 项（n=19）的大部分骨折发生在骨溶解后。骨折后的治疗策略包括关节镜下 Bankart 修复术或开放 Bristow/Latarjet 手术。
在男性、25 岁或以下、运动参与者、初始使用 3 个或更多锚钉或传统结系锚钉固定或锚钉部位发生骨溶解的患者中，经常报告邮票样骨折。
IV 级，对 III 级和 IV 级研究的系统评价。
