Shen Zhe-Yuan, Wu Rong, Peng Qiao-Ying, Li Heng, Guo Song-Hua, Zhang Zhan-Feng
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China; Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China.
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China.
Zhongguo Gu Shang. 2025 Mar 25;38(3):223-30. doi: 10.12200/j.issn.1003-0034.20240947.
To compare clinical effect of arthroscopic double row fixation and single row fixation in treating Ideberg typeⅠA scapular glenoid fracture.
From June 2018 to December 2022, 26 patients with Ideberg typeⅠA scapular glenoid fracture treated with shoulder arthroscopy were divided into single-row anchor group and double-row anchor group according to the fixation method of fracture block. There were 12 patients in single-row anchor group, including 7 males and 5 females, aged from 25 to 53 years old with an average of (38.42±9.61) years old;the time from injury to operation ranged from 2 to 7 days with an average of (4.75±1.82) days. There were 14 patients in double-row anchor group, including 10 males and 4 females, aged from 21to 53 years old with an average of (37.36±10.19) years old;the time from injury to operation ranged from 1 to 8 days with an average of (4.21±2.01) days. The changes of shoulder joint flexion, abduction, lateral lateral rotation, Constant-Murley shoulder function score and Rowe scores were compared between two groups before operation and 1 year after operation. The percentage of bone mass in pelvis area before operation and the percentage of bone defect in pelvis area at the latest follow-up were compared between two groups.
All patients were followed up for 12 to 15 months with an average of (13.08±1.17) months in single-row anchor group and 12 to 15 months with an average of (13.29±1.07) months in double-row anchor group, with no statistical significance between two groups (>0.05). The results of anterior flexion, abduction and lateral lateral rotation in single-row anchor group were(86.67±6.62) °, (79.50±5.68) °, (38.17±1.70) ° before operation, and (162.50±4.52)°, (169.17±3.35)°, (50.67±10.20)° at 1 year after operation; while in double-row anchor group were (84.14±5.48) °, (81.71±5.20) °, (39.29±3.63) ° before operation and (162.29 ± 5.53) °, (167.14±3.61) °, (56.93±9.56) ° at 1 year after operation;the difference between two groups before operation and 1 year after operation was statistically significant (<0.05). There were no significant difference between two groups (>0.05). Constant-Murley scores and Rowe scores in single-row anchor group were (55.42±3.75), (43.75±18.49) before operation and (94.83±2.21), (95.42±4.50) at 1 year after operation, respectively;while in double-row anchor group were (54.50±7.88), (41.79±18.25) before operation and (94.36±4.73), (95.00±4.80) at 1 year after operation;there was no significant difference in Constant-Murley score and Rowe score between two groups before operation and 1 year after operation (>0.05). There was significant difference in the percentage of bone mass in pelvis area between two groups before operation (>0.05). There was no significant difference in the percentage of bone defect in the shoulder area between single-row anchor group(4.42±1.51)% and double-row anchor group (2.71±1.44)% at 1 year after operation (<0.05).
Both single and double row fixation techniques for the treatment of Ideberg typeⅠA scapular glenoid fracture could receive satisfactory functional recovery. However, double-row fixation has more advantages in reducing bone resorption of fracture mass.
比较关节镜下双排固定与单排固定治疗IdebergⅠA型肩胛盂骨折的临床效果。
选取2018年6月至2022年12月期间采用肩关节镜治疗的26例IdebergⅠA型肩胛盂骨折患者，根据骨折块固定方式分为单排锚钉组和双排锚钉组。单排锚钉组12例，男7例，女5例，年龄25～53岁，平均（38.42±9.61）岁；受伤至手术时间2～7天，平均（4.75±1.82）天。双排锚钉组14例，男10例，女4例，年龄21～53岁，平均（37.36±10.19）岁；受伤至手术时间1～8天，平均（4.21±2.01）天。比较两组患者术前及术后1年肩关节前屈、外展、外旋活动度，Constant-Murley肩关节功能评分及Rowe评分。比较两组患者术前骨盆区域骨量百分比及末次随访时骨盆区域骨缺损百分比。
所有患者均获随访，单排锚钉组随访12～15个月，平均（13.08±1.17）个月；双排锚钉组随访12～15个月，平均（13.29±1.0）个月，两组比较差异无统计学意义（>0.05）。单排锚钉组术前前屈、外展、外旋活动度分别为（86.67±6.62）°、（79.50±5.68）°、（38.17±1.70）°，术后1年分别为（162.50±4.52）°、（169.17±3.35）°、（50.67±10.20）°；双排锚钉组术前分别为（84.14±5.48）°、（81.71±5.20）°、（39.29±3.63）°，术后1年分别为（162.29±5.53）°、（167.14±3.61）°、（56.93±9.56）°；两组术前及术后1年比较差异有统计学意义（<0.05）。两组间比较差异无统计学意义（>0.）。单排锚钉组术前Constant-Murley评分及Rowe评分分别为（55.42±3.75）、（43.75±18.49），术后1年分别为（94.83±2.21）、（95.42±4.50）；双排锚钉组术前分别为（54.50±7.88）、（41.79±18.25），术后1年分别为（94.36±4.73）、（95.00±4.80）；两组术前及术后1年Constant-Murley评分及Rowe评分比较差异无统计学意义（>0.05）。两组术前骨盆区域骨量百分比比较差异有统计学意义（>0.05）。单排锚钉组术后1年肩部骨缺损百分比为（4.42±1.51）%，双排锚钉组为（2.71±1.44）%，两组比较差异无统计学意义（<0.05）。
单排和双排固定技术治疗IdebergⅠA型肩胛盂骨折均可获得满意的功能恢复。但双排固定在减少骨折块骨吸收方面更具优势。
