Abstract
Ten patients after traumatic shoulder dislocation with resulting instability due to an acute anterior glenoid fracture involving at least 21 percent of the glenoid length were treated by arthroscopic screw fixation of the fragment. The average fragment size measured 26.2% of the glenoid length. Pre- and postoperative radiographic evaluations were performed with three-dimensional CT scans. A cannulated titanium screw system was used for fragment fixation. All ten patients were followed up radiographically and, by evaluation of the Rowe score, clinically after a minimum of 2 years. At follow-up the Rowe score averaged 94 points. According to the rating scale, seven patients had an excellent result, two patients a good result, and one, fair result. In all patients CT scan confirmed that the fracture had healed in an anatomical position. One patient had one episode of traumatic redislocation with a positive apprehension test at follow up. In one case, removal of the screw was necessary due to mechanical impingement. We recommend this arthroscopic technique allowing for closed reduction and internal screw fixation of large anterior glenoid fractures, ensuring anatomical fracture healing and gleno-humeral joint stability.
Similar content being viewed by others
References
Aston JW Jr, Gregory CF (1973) Dislocation of the shoulder with significant fracture of the glenoid. J Bone Joint Surg Am 55(7):1531–1533
Kummel BM (1970) Fractures of the glenoid causing chronic dislocation of the shoulder. Clin Orthop Relat Res 69:189–191
Goss TP (1992) Fractures of the glenoid cavity. J Bone Joint Surg Am 74(2):299–305
Rockwood CA, Matsen FA (1990) The scapula. In: Butters KP (ed) The shoulder. WB Saunders, Philadelphia, pp 345–353
De Palma AF (1983) Fractures and fracture-dislocations of the shoulder girdle. In: Jacob RP, Kristainsen T, Mayo K et al (eds) Surgery of the shoulder, edn 3. JB Lippincott, Philadelphia, pp 366–367
Bauer T, Abadie O, Hardy P (2006) Arthroscopic treatment of glenoid fractures. Arthroscopy 22(5):569–576
Cameron SE (1998) Arthroscopic reduction and internal fixation of an anterior glenoid fracture. Arthroscopy 14(7):743–746
Carro LP, Nunez MP, Llata JI (1999) Arthroscopic-assisted reduction and percutaneous external fixation of a displaced intra-articular glenoid fracture. Arthroscopy 15(2):211–214
Gigante A, Marinelli M, Verdenelli A, Lupetti E, Greco F (2003) Arthroscopy-assisted reduction and percutaneous fixation of a multiple glenoid fracture. Knee Surg Sports Traumatol Arthrosc 11(2):112–115
Sugaya H, Kon Y, Tsuchiya A (2005) Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy 21(5):635
Kavanagh BF, Bradway JK, Cofield RH (1993) Open reduction and internal fixation of displaced intra-articular fractures of the glenoid fossa. J Bone Joint Surg Am 75(4):479–484
Kligman M, Roffman M (1998) Glenoid fracture: conservative treatment versus surgical treatment. J South Orthop Assoc 7(1):1–5
Mayo KA, Benirschke SK, Mast JW (1998) Displaced fractures of the glenoid fossa. Results of open reduction and internal fixation. Clin Orthop Relat Res 347:122–130
Schandelmaier P, Blauth M, Schneider C, Krettek C (2002) Fractures of the glenoid treated by operation. A 5- to 23-year follow-up of 22 cases. J Bone Joint Surg Br 84(2):173–177
Porcellini G, Campi F, Paladini P (2002) Arthroscopic approach to acute bony Bankart lesion. Arthroscopy 18(7):764–769
Itoi E, Lee SB, Berglund LJ, Berge LL, An KN (2000) The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 82(1):35–46
Ideberg R, Grevsten S, Larsson S (1995) Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand 66(5):395–397
Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 60(1):1–16
Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85-A(5):878–884
Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428
Resch H, Wykypiel HF, Maurer H, Wambacher M (1996) The antero-inferior (transmuscular) approach for arthroscopic repair of the Bankart lesion: an anatomic and clinical study. Arthroscopy 12(3):309–319
Seybold D, Gekle C, Muhr G, Kalicke T (2006) Severe complications after percutaneous transaxillary refixation of a glenoid rim fracture. Unfallchirurg 109(1):72–77
Weber SC, Abrams JS, Nottage WM (2002) Complications associated with arthroscopic shoulder surgery. Arthroscopy 18(2 Suppl 1):88–95
Scheibel M, Tsynman A, Magosch P, Schroeder RJ, Habermeyer P (2006) Postoperative subscapularis muscle insufficiency after primary and revision open shoulder stabilization. Am J Sports Med 34(10):1586–1593
Scheibel M, Magosch P, Lichtenberg S, Habermeyer P (2004) Open reconstruction of anterior glenoid rim fractures. Knee Surg Sports Traumatol Arthrosc 12(6):568–573
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tauber, M., Moursy, M., Eppel, M. et al. Arthroscopic screw fixation of large anterior glenoid fractures. Knee Surg Sports Traumatol Arthr 16, 326–332 (2008). https://doi.org/10.1007/s00167-007-0437-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-007-0437-2