Department of Orthopedic Surgery, College of Medicine, Ewha Womans University Seoul Hospital, 260 Gonghang-daero, Gangseo-Gu, Seoul, 07804, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2681-2687. doi: 10.1007/s00167-023-07389-w. Epub 2023 Mar 30.
To introduce a novel surgical technique for arthroscopic reduction and double-row bridge fixation using trans-subscapularis tendon portal for anterior glenoid fracture and to evaluate the clinical and radiological outcomes.
A total of 22 patients who underwent arthroscopic reduction and double-row bridge fixation for an acute anterior glenoid fracture were retrospectively evaluated. Arthroscopic surgery was performed using four portals including a trans-subscapularis tendon portal. All patients underwent 3D-CT preoperatively and one day and one year postoperatively to evaluate the fracture fragment size, reduction status, and presence of fracture union. To evaluate the degree of fragment displacement, articular step-off and medial fracture gap were measured using 3D-CT. Clinical outcomes were assessed based on the ASES and Constant scores. Postoperative glenohumeral joint arthritis was evaluated using plain radiographs with the Samilson and Prieto classification.
The average preoperative fracture fragment size was 25.9 ± 5.6%. Articular step-off (preoperative: 6.0 ± 3.3 mm, postoperative one day: 1.1 ± 1.6 mm, P < 0.001) and medial fracture gap (preoperative: 5.2 ± 2.6 mm, postoperative one day: 1.9 ± 2.3 mm, P < 0.001) were improved after surgery. On the postoperative one year 3D-CT, 20 patients achieved complete fracture union, and two patients showed partial union. Postoperative glenohumeral joint arthritis was observed in four patients. At the last visit, the ASES score was 91.8 ± 7.0 and the Constant score was 91.6 ± 7.0.
Arthroscopic reduction and double-row bridge fixation using a trans-subscapularis tendon portal for acute anterior glenoid fracture achieved satisfactory clinical outcomes and anatomical reduction as demonstrated by a low degree of articular step-off and medial fracture gap.
Level IV.
介绍一种经肩胛下肌腱隧道关节镜下复位双排桥接固定治疗急性前盂唇骨折的新手术技术，并评估其临床和影像学结果。
回顾性分析 22 例急性前盂唇骨折患者行关节镜下复位双排桥接固定的病例。手术采用包括肩胛下肌腱隧道在内的四个入路进行。所有患者均在术前和术后 1 天及 1 年进行 3D-CT 检查，以评估骨折块大小、复位情况和骨折愈合情况。采用 3D-CT 测量关节台阶和内侧骨折间隙来评估骨折块移位程度。根据 ASES 和 Constant 评分评估临床结果。术后肩关节关节炎采用平片评估，采用 Samilson 和 Prieto 分类。
术前骨折块平均大小为 25.9±5.6%。关节台阶（术前：6.0±3.3mm，术后 1 天：1.1±1.6mm，P<0.001）和内侧骨折间隙（术前：5.2±2.6mm，术后 1 天：1.9±2.3mm，P<0.001）在手术后均得到改善。术后 1 年 3D-CT 显示 20 例患者骨折完全愈合，2 例患者部分愈合。术后有 4 例患者出现肩关节关节炎。末次随访时，ASES 评分为 91.8±7.0，Constant 评分为 91.6±7.0。
经肩胛下肌腱隧道关节镜下复位双排桥接固定治疗急性前盂唇骨折可获得满意的临床和解剖复位结果，关节台阶和内侧骨折间隙较小。
IV 级。
