Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital -NYU Langone Health, 333 East 38th Street, New York, NY, 10016, USA.
Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2297-2302. doi: 10.1007/s00590-022-03424-7. Epub 2022 Nov 8.
The purpose of this series is to report on the one-year clinical outcomes of instability related anterior glenoid fractures treated with open repair utilizing the subscapularis split technique.
Patients with displaced anterior glenoid fractures who underwent open surgical treatment via deltopectoral incision and subscapularis split were identified from a single surgeons database. Fractures were repaired using screw fixation or with distal tibia osteochondral allograft reconstruction. Patient Reported Outcome Measurement Information System (PROMIS) Upper Extremity Computer Adaptive Test (UE), PROMIS Pain interference (PI), PROMIS pain intensity (Pi), American Shoulder and Elbow Surgeons (ASES), Visual Analog Scale (VAS) pain, and Subjective Shoulder Value (SSV) scores were obtained at minimum one-year follow-up.
Twelve patients with a mean age of 54 (range 28-72) years were included in our study with a follow-up at an average of 16.6 (range 12-30) months. Ten patients underwent internal fixation and two patients underwent allograft reconstruction. Postoperative imaging (n = 10) at latest follow-up demonstrated healed fractures without any hardware complication. Mean postoperative range of motion included forward elevation of 147 ± 44.0° and external rotation of 44 ± 17°. Postoperative PROMs were obtained from nine patients with a mean PROMIS UE, PI, and Pi score of 49.4 ± 4.1, 39.9 ± 3.8 and 35.6 ± 4.3, respectively. The respective mean ASES, VAS, and SSV scores were 91.8 ± 7.2, 1.2 ± 1.0, and 91.0 ± 8.0.
Open surgical repair of anterior glenoid fractures utilizing subscapularis split results in good functional outcomes and low complications including risk of recurrent instability.
III case series.
本系列旨在报告采用肩胛下肌劈开技术行切开复位治疗不稳定相关前盂肱关节骨折的一年临床结果。
从一位外科医生的数据库中确定了接受经三角肌胸大肌入路和肩胛下肌劈开的切开复位手术治疗的移位前盂肱关节骨折患者。使用螺钉固定或使用胫骨远端骨软骨同种异体移植重建修复骨折。在至少一年的随访中，获得患者报告的结局测量信息系统（PROMIS）上肢计算机自适应测试（UE）、PROMIS 疼痛干扰（PI）、PROMIS 疼痛强度（Pi）、美国肩肘外科医生协会（ASES）、视觉模拟评分（VAS）疼痛和主观肩部值（SSV）评分。
本研究共纳入 12 例患者，平均年龄 54 岁（28-72 岁），平均随访 16.6 个月（12-30 个月）。10 例患者接受内固定治疗，2 例患者接受同种异体移植重建。末次随访时（n=10）的术后影像学检查显示骨折愈合，无任何内固定并发症。术后平均运动范围包括前向抬高 147±44.0°和外旋 44±17°。术后获得 9 例患者的 PROMs，平均 PROMIS UE、PI 和 Pi 评分为 49.4±4.1、39.9±3.8 和 35.6±4.3。相应的平均 ASES、VAS 和 SSV 评分为 91.8±7.2、1.2±1.0 和 91.0±8.0。
采用肩胛下肌劈开切开复位治疗前盂肱关节骨折可获得良好的功能结果，且并发症低，包括复发性不稳定的风险。
III 级病例系列。
