Liles Jordan, Smith Corey, Su Charles, Vopat Matthew, Provencher Capt Matthew T
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
The Steadman Clinic, Vail, Colorado, U.S.A.
Arthrosc Tech. 2023 Jan 18;12(2):e207-e215. doi: 10.1016/j.eats.2022.10.010. eCollection 2023 Feb.
The "postage stamp fracture" is an anterior glenoid rim fracture following arthroscopic repair of a Bankart lesion. Often occurring at the time of an acute trauma, a fracture line propagates though the previous Bankart repair anchor sites, resulting in recurrent anterior instability of the glenohumeral joint. The resultant glenoid rim fracture edge gives a similar appearance as the edge of a stamp, with the osseous edge having the classic "perforation" pattern. When patients present with a postage stamp fracture, even in the setting of subcritical glenoid bone loss, we believe that additional soft-tissue stabilization procedures and/or fracture fixation pose a significant risk of failure. In our opinion, a Latarjet procedure is recommended in a majority of patients with a postage stamp fracture for restoration of glenohumeral stability. The procedure offers a reliable, reproducible surgical intervention that controls for many of the factors that can make arthroscopic revision unreliable, such as poor bone quality, adhesions, labral degeneration, and bone loss. Here, we outline our preferred surgical technique to restore glenohumeral stability using the Latarjet procedure for a patient with a postage stamp fracture.
“邮票样骨折”是在Bankart损伤关节镜修复术后发生的一种肩胛盂前缘骨折。常发生于急性创伤时，骨折线穿过先前Bankart修复的锚钉部位，导致盂肱关节复发性前向不稳定。由此产生的肩胛盂边缘骨折边缘与邮票边缘外观相似，骨质边缘具有典型的“穿孔”模式。当患者出现邮票样骨折时，即使在肩胛盂骨量临界减少的情况下，我们认为额外的软组织稳定手术和/或骨折固定有显著的失败风险。我们认为，对于大多数邮票样骨折患者，推荐采用Latarjet手术来恢复盂肱关节稳定性。该手术提供了一种可靠、可重复的外科干预措施，可控制许多会使关节镜翻修手术不可靠的因素，如骨质不佳、粘连、盂唇退变和骨量减少。在此，我们概述了使用Latarjet手术为一名邮票样骨折患者恢复盂肱关节稳定性的首选手术技术。
