Schoen Clinic Munich Harlaching, Munich, Germany; Center for Musculoskeletal Surgery (MUM), Ludwig-Maximilians-University, Munich, Germany; Schulthess Clinic Zurich, Zurich, Switzerland.
Center for Musculoskeletal Surgery (CMSC), Charité-Universitaetsmedizin Berlin, Berlin, Germany.
J Shoulder Elbow Surg. 2024 Dec;33(12):2893-2898. doi: 10.1016/j.jse.2024.07.027. Epub 2024 Sep 5.
To date, long-term results of the arthroscopic repair of glenoid rim fractures are missing. The aim of this study was, to evaluate clinical and radiographic results following arthroscopic repair of anteroinferior glenoid fractures using anchors or bioabsorbable compression screws after a mean follow-up period of 10 years.
Clinical outcome measures included evaluation of recurrent instability, the Constant Score, Subjective Shoulder Value, Rowe Score (RS), Western Ontario Shoulder Instability Score, and Melbourne Instability Shoulder Score. X-ray images were obtained for assessment of an instability arthropathy (IA).
Twenty-three patients (7 female and 16 male, mean (±standard deviation) age 48 ± 15 years) who underwent arthroscopic repair of an acute substantial solitary or multifragmented anteroinferior glenoid rim fracture were enrolled. After a mean follow-up period of 10 ± 2 years, patients reached a mean Constant Score of 92 ± 10 points, Subjective Shoulder Value of 93 ± 11%, RS of 84 ± 20 points, Western Ontario Shoulder Instability Score of 98 ± 2%, and Melbourne Instability Shoulder Score of 91 ± 11 points. No patient suffered recurrent dislocation. Radiographic results were obtained of 18 patients. Signs of IA were noted in 9 patients (50%) with progression of IA in all cases in comparison to the preoperative status. Patients with IA were significantly older (52 vs. 38 years, P = .04). Clinical score results did not show a significant difference in patients with vs. without IA except for the RS (74 vs. 94 points, P = .02). No intraoperative or postoperative complications were observed, and no patient required revision endoprosthetic surgery.
Arthroscopic repair of acute anteroinferior glenoid rim fractures shows good clinical long-term results. High rates of IA were observed especially in older patients. However, the presence of IA did not seem to influence the subjective shoulder score outcomes.
迄今为止，关节镜下修复肩胛盂缘骨折的长期结果尚不清楚。本研究的目的是评估使用锚钉或可吸收压缩螺钉在平均 10 年的随访后，关节镜下修复前下肩胛盂缘骨折的临床和影像学结果。
临床结果评估包括复发性不稳定、Constant 评分、主观肩部值、Rowe 评分（RS）、安大略西部肩不稳定评分和墨尔本不稳定肩评分。获取 X 射线图像以评估不稳定关节炎（IA）。
共纳入 23 例（7 例女性，16 例男性，平均年龄 48±15 岁）急性、大量、单一或多发性前下肩胛盂缘骨折患者。在平均 10±2 年的随访后，患者达到平均 Constant 评分为 92±10 分，主观肩部值为 93±11%，RS 为 84±20 分，安大略西部肩不稳定评分为 98±2%，墨尔本不稳定肩评分为 91±11%。无患者发生复发性脱位。18 例患者获得影像学结果。9 例（50%）患者出现 IA 征象，与术前相比，所有病例的 IA 均有进展。有 IA 的患者年龄明显较大（52 岁 vs. 38 岁，P=0.04）。除 RS（74 分 vs. 94 分，P=0.02）外，IA 患者与无 IA 患者的临床评分结果无显著差异。未观察到术中或术后并发症，也无需翻修关节成形术。
关节镜下修复急性前下肩胛盂缘骨折具有良好的长期临床结果。特别是在老年患者中，观察到较高的 IA 发生率。然而，IA 的存在似乎并不影响主观肩部评分结果。
