Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

Kim,  Se Jin; Lee,  Sung Hyun; Jung,  Dae Woong; Kim,  Jeong Woo

doi:2017.20.3.147

Clin Shoulder Elb > Volume 20(3); 2017 > Article

Original Article

Clinics in Shoulder and Elbow 2017;20(3):147-152.
DOI: https://doi.org/10.5397/cise.2017.20.3.147 Published online September 30, 2017.

Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

Se Jin Kim, Sung Hyun Lee, Dae Woong Jung, Jeong Woo Kim

¹Department of Orthopedic Surgery, St. Carollo Hospital, Suncheon, Korea.
²Institute of Wonkwang Medical Science and Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Korea. serina@wonkwang.ac.kr

Received: 5 June 2017 • Revised: 24 July 2017 • Accepted: 30 July 2017

Abstract

BACKGROUND: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results.
METHODS
We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up.
RESULTS
Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication.
CONCLUSIONS
We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.

Key Words: Arthroscopy; Fracture fixation; Scapula; Glenoid cavity