Skip to main content
Log in

Arthroscopic screw fixation of large anterior glenoid fractures

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. 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

    PubMed  Google Scholar 

  2. Kummel BM (1970) Fractures of the glenoid causing chronic dislocation of the shoulder. Clin Orthop Relat Res 69:189–191

    Article  PubMed  CAS  Google Scholar 

  3. Goss TP (1992) Fractures of the glenoid cavity. J Bone Joint Surg Am 74(2):299–305

    PubMed  CAS  Google Scholar 

  4. Rockwood CA, Matsen FA (1990) The scapula. In: Butters KP (ed) The shoulder. WB Saunders, Philadelphia, pp 345–353

    Google Scholar 

  5. 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

    Google Scholar 

  6. Bauer T, Abadie O, Hardy P (2006) Arthroscopic treatment of glenoid fractures. Arthroscopy 22(5):569–576

    Article  PubMed  Google Scholar 

  7. Cameron SE (1998) Arthroscopic reduction and internal fixation of an anterior glenoid fracture. Arthroscopy 14(7):743–746

    Article  PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. 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

    PubMed  Google Scholar 

  10. Sugaya H, Kon Y, Tsuchiya A (2005) Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy 21(5):635

    Article  PubMed  Google Scholar 

  11. 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

    PubMed  CAS  Google Scholar 

  12. Kligman M, Roffman M (1998) Glenoid fracture: conservative treatment versus surgical treatment. J South Orthop Assoc 7(1):1–5

    PubMed  CAS  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. Porcellini G, Campi F, Paladini P (2002) Arthroscopic approach to acute bony Bankart lesion. Arthroscopy 18(7):764–769

    Article  PubMed  Google Scholar 

  16. 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

    PubMed  CAS  Google Scholar 

  17. Ideberg R, Grevsten S, Larsson S (1995) Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand 66(5):395–397

    Article  PubMed  CAS  Google Scholar 

  18. 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

    PubMed  CAS  Google Scholar 

  19. 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

    PubMed  Google Scholar 

  20. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428

    Article  CAS  PubMed  Google Scholar 

  21. 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

    Article  PubMed  CAS  Google Scholar 

  22. 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

    Article  PubMed  CAS  Google Scholar 

  23. Weber SC, Abrams JS, Nottage WM (2002) Complications associated with arthroscopic shoulder surgery. Arthroscopy 18(2 Suppl 1):88–95

    Article  PubMed  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark Tauber.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-007-0437-2

Keywords

Navigation