Wu Di, Zhang Guangcheng, Zhou Zhekun, Song Wei, Chen Daoyun, Bai Zhenlong, Yu Weilin, He Yaohua
Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Shoulder Elbow Surg. 2025 Apr;34(4):944-954. doi: 10.1016/j.jse.2024.07.013. Epub 2024 Aug 24.
The purpose of the present study was to retrospectively compare the clinical and radiologic outcomes of arthroscopic suture anchor fixation and open screw fixation for acute large anterior glenoid rim fractures.
This study enrolled patients with acute large anterior glenoid rim fractures treated with arthroscopic suture anchor fixation (group A) or open screw fixation (group O) from January 2013 to June 2020 with a minimum follow-up of＞2 years. The Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, Rowe score, Constant score, range of motion, recurrent instability rate, and complications were recorded as clinical results. The quality of the postoperative reduction, reconstructed glenoid sizes, rate of fracture healing, and progression of osteoarthritis (OA) were evaluated as radiologic outcomes.
This retrospective study included 66 patients, including 37 in Group A and 29 in Group O with a mean follow-up of 46.9 (range: 24.3-94.2) months and a mean patient age of 46.8 (range: 21-69) years. No significant differences were found in the clinical outcomes between the two groups. A significant range of motion limitation in all planes was found in both groups and group O showed more limitations in external rotation at the side (18° vs. 10°, P = .002). The reduction quality was better in group O (P < .001). However, there was no significant difference between the two groups in terms of reconstructed glenoid size (101.6% ± 4.6% vs. 100.6% ± 7.1%, P = .460) and the rate of OA progression (26.9% vs. 20%, P = .525).
Arthroscopic suture anchor fixation and open screw fixation achieved similar clinical outcomes, reconstructed glenoid sizes, and OA progression in patients with acute large anterior glenoid rim fractures. Arthroscopic suture fixation showed a poorer quality of reduction but less external rotation at the side limitations.
本研究的目的是回顾性比较关节镜下缝线锚钉固定与切开螺钉固定治疗急性大型前盂缘骨折的临床和影像学结果。
本研究纳入了2013年1月至2020年6月期间接受关节镜下缝线锚钉固定（A组）或切开螺钉固定（O组）治疗的急性大型前盂缘骨折患者，最小随访时间＞2年。记录主观肩关节评价值、美国肩肘外科医师评分、Rowe评分、Constant评分、活动范围、复发性不稳定率和并发症作为临床结果。将术后复位质量、重建盂的大小、骨折愈合率和骨关节炎（OA）进展情况评估为影像学结果。
这项回顾性研究包括66例患者，其中A组37例，O组29例，平均随访46.9（范围：24.3 - 94.2）个月，患者平均年龄46.8（范围：21 - 69）岁。两组临床结果无显著差异。两组在所有平面均发现明显的活动范围受限，且O组在外旋时的活动受限更明显（18°对10°，P = 0.002）。O组的复位质量更好（P < 0.001）。然而，两组在重建盂的大小（101.6% ± 4.6%对100.6% ± 7.1%，P = 0.460）和OA进展率（26.9%对20%，P = 0.525）方面无显著差异。
关节镜下缝线锚钉固定与切开螺钉固定在急性大型前盂缘骨折患者中取得了相似的临床结果、重建盂大小和OA进展情况。关节镜下缝线固定显示复位质量较差，但外旋时的侧方活动受限较少。
