Istanbul Gelisim University, Faculty of Health Sciences, Istanbul, Turkey.
Beyzadeoglu Clinic, Orthopaedics and Traumatology, Istanbul, Turkey.
Acta Chir Orthop Traumatol Cech. 2021;88(6):456-460.
Bio-absorbable anchors are widely used for Bankart repair in shoulder instability surgery. Suture anchor placement for labral repair may give rise to osteolysis and/or create stress risers in the glenoid rim, which may be the underlying reasons for glenoid rim fracture with a fracture line passing through previous anchor placement sites, the so-called "postage stamp fracture". Intraarticular fractures of the glenoid have been treated via open reduction and internal fixation through an arthrotomy, which may lead to potential postoperative complications like infection, neurovascular injuries, joint stiffness, and a long recovery period. Thus, arthroscopic techniques for the reduction and fixation of glenoid fractures have been developed. We present a case of anterior glenoid rim postage stamp fracture 9 years after glenohumeral instability surgery in a 29- year-old male. The fracture and recurrent instability were treated via arthroscopic Bankart revision repair and arthroscopic assisted percutaneous screw fixation, where the arthroscopic fracture reduction and definitive fixation were performed separately and before Bankart repair, which is different from the techniques defined in the literature previously. The patient was able to return to work at 6 weeks, to fitness training without pain or restriction at 3 months, and contact sports 6 months postoperatively. Key words: Bankart fractures, bony Bankart lesion, osseous Bankart lesion, shoulder dislocation, arthroscopy.
生物可吸收锚广泛应用于肩不稳定手术中的 Bankart 修复。用于盂唇修复的缝线锚钉可能会引起溶骨和/或在肩胛盂边缘产生应力集中,这可能是肩胛盂边缘骨折的根本原因,骨折线穿过先前的锚钉放置部位,即所谓的“邮票样骨折”。通过关节切开术进行开放复位和内固定可治疗关节内的肩胛盂骨折,但可能会导致术后并发症,如感染、神经血管损伤、关节僵硬和恢复时间长。因此,已经开发出用于肩胛盂骨折复位和固定的关节镜技术。我们报告了 1 例 29 岁男性在肩关节不稳定手术后 9 年发生的前肩胛盂边缘邮票样骨折病例。该患者通过关节镜 Bankart 翻修修复和关节镜辅助经皮螺钉固定治疗骨折和复发性不稳定,其中关节镜下骨折复位和确定性固定是分别进行的,并且在 Bankart 修复之前进行,这与之前文献中定义的技术不同。患者术后 6 周即可恢复工作,3 个月时可进行无疼痛或限制的健身训练,6 个月后可进行接触性运动。关键词:Bankart 骨折、骨 Bankart 损伤、骨 Bankart 病变、肩关节脱位、关节镜检查。