Toru Matsugaki, Hideaki Shibata, Tsunemasa Matsubara
Department of Orthopaedic Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka City, Japan.
Trauma Case Rep. 2020 Oct 9;30:100363. doi: 10.1016/j.tcr.2020.100363. eCollection 2020 Dec.
Ideberg type III glenoid fractures are relatively rare, and the mechanisms of injury and treatment strategies remain controversial. We reviewed the fracture patterns and final radiological findings in four cases. All fractures were wider on the medial side than on the side of the articular surface. All patients had multiple ipsilateral rib fractures; three out of four patients had a concomitant acromion fracture. Therefore, the mechanism of injury for the fracture is assumed to be external force applied in the caudal direction to the medial side of the body of the scapula. The superior shoulder suspensory complex was disrupted in most cases. A good clinical outcome was obtained in two patients with percutaneous screw fixation for the glenoid fracture and rigid plate fixation for the acromion fracture and in one patient who did not have an acromion fracture. However, one patient who did not undergo fixation of the acromion fracture developed osteoarthrosis of the shoulder joint. In this type of fracture, it is important to stabilize the acromion fracture at the same time as fixation of the glenoid fracture.
IdebergⅢ型肩胛盂骨折相对少见,其损伤机制及治疗策略仍存在争议。我们回顾了4例患者的骨折类型及最终影像学表现。所有骨折在内侧均比关节面侧更宽。所有患者均有同侧多发肋骨骨折;4例患者中有3例合并肩峰骨折。因此,推测该骨折的损伤机制是向肩胛盂体部内侧施加的尾侧外力。多数病例中,肩上部悬吊复合体遭到破坏。2例采用经皮螺钉固定肩胛盂骨折及钢板固定肩峰骨折的患者,以及1例未发生肩峰骨折的患者,均获得了良好的临床疗效。然而,1例未行肩峰骨折固定的患者发生了肩关节骨关节炎。对于此类骨折,在固定肩胛盂骨折的同时稳定肩峰骨折很重要。