Chalidis Byron, Papadopoulos Polychronis P, Papadopoulos Pericles, Pitsilos Charalampos
1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece.
2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece.
Diagnostics (Basel). 2024 Apr 26;14(9):908. doi: 10.3390/diagnostics14090908.
Glenoid fossa fractures are rare injuries accounting for 10 to 29% of all intra-articular scapula fractures. They are usually the result of high-energy trauma, and concomitant injuries are not uncommon. Patients with glenoid fractures are admitted with shoulder pain and restricted range of motion. Although shoulder plain radiographs could establish the diagnosis, a computed tomography scan is necessary to adequately define the fracture pattern and characteristics. The most commonly used classification system is that of Ideberg (modified by Goss), which includes five glenoid fossa fracture types according to the location, extension, and complexity of the lesion. Articular surface displacement and step-off are the most important factors that should be taken under consideration when deciding for conservative or surgical management. Operative treatment includes open reduction and internal fixation through a posterior or anterior approach depending on fracture morphology and displacement. However, open surgical techniques are related to extensive soft-tissue disruption, risk of neurovascular injury, and inadequate exposure of the entire glenoid cavity. Introduction of arthroscopy could facilitate better visualization of the glenoid articular surface and improved fracture reduction. However, it is a technically demanding procedure with many challenges and pitfalls. The aim of this review is to summarize the current evidence regarding the treatment of glenoid fossa fractures and present the beneficial effect of arthroscopy in improving the quality of fracture fixation and overall functional outcomes.
肩胛盂骨折是罕见损伤，占所有关节内肩胛骨骨折的10%至29%。它们通常是高能创伤的结果，并发损伤并不少见。肩胛盂骨折患者因肩部疼痛和活动范围受限而入院。虽然肩部X线平片可确诊，但计算机断层扫描对于充分明确骨折类型和特征是必要的。最常用的分类系统是伊德伯格（由戈斯修改）分类系统，根据损伤的位置、范围和复杂程度，该系统包括五种肩胛盂骨折类型。关节面移位和台阶样改变是决定保守治疗或手术治疗时应考虑的最重要因素。手术治疗包括根据骨折形态和移位情况通过后路或前路入路进行切开复位内固定。然而，开放手术技术会导致广泛的软组织破坏、神经血管损伤风险以及肩胛盂腔暴露不充分。关节镜的引入有助于更好地观察肩胛盂关节面并改善骨折复位。然而，这是一项技术要求高的手术，存在许多挑战和陷阱。本综述的目的是总结目前关于肩胛盂骨折治疗的证据，并阐述关节镜在改善骨折固定质量和总体功能结局方面的有益作用。
