Treatment of Ideberg type Ⅱ scapular glenoid fracture with compression screw combined with Buttress plate through direct axillary approach / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures.@*METHODS@#A retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function.@*RESULTS@#The operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient's shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation ( P<0.05).@*CONCLUSION@#Compression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.

Treatment of scapular glenoid fractures via the modified Judet approach / 中华创伤骨科杂志

Objective:To analyze the treatment of scapular glenoid fractures via the modified Judet approach.Methods:A retrospective study was conducted of the 25 patients who had been treated for scapular glenoid fractures via the modified Judet approach and completely followed up at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2014 to January 2020. They were 19 males and 6 females with an average age of 46 years (from 29 to 66 years). According to the Goss-Ideberg classification, 8 cases were diagnosed as type Ⅱ, 2 cases as type Ⅳ, 10 cases as type Ⅴ and 5 cases as type Ⅵ. 3D reconstruction of the CT scans by software Mimics 16.0 was made to confirm the diagnoses and classifications of the fractures. Articular step-off and displacement of the scapular glenoid were calculated and recorded. The functional outcomes were evaluated by Constant-Murley scoring system at 6 months postoperatively.Results:Preoperatively, the mean articular step-off was 5.8 mm (from 1.2 to 6.3 mm) and the mean displacement 7.7 mm (from 2.1 to 12.9 mm). All fractures obtained bony union within postoperative 6 months. The mean follow-up period was 58.8 months (from 7 to 92 months). The forward flexion was 158.6° (from 125° to 180°) and the external rotation 39.0° (from 30° to 45°) at 6 months postoperatively. The mean Constant-Murley score was 92.6 (from 75 to 100) at 6 months post-operatively; 19 cases were excellent (76%), 5 were good (20%) and one was fair (4%), giving an excellent to good rate of 96% (24/25).Conclusion:For scapular glenoid fractures of Goss-Ideberg types Ⅱ/Ⅳ/Ⅴ/Ⅵ, surgery via the modified Judet approach may promise satisfactory reduction and fixation and fine clinical outcomes.

Fractura de cavidad glenoidea: reporte de un caso / Glenoid fossa fracture: case report

Las fracturas del componente craneofacial aumentan su frecuencia y severidad día con día en las salas de urgencias. Las disrupciones de la mandíbula pueden clasificarse de acuerdo a su localización anatómica, siendo más frecuentes las del ángulo (36.3%) y el cuerpo (21.2%) y poco comunes las de apófisis coronoides (0.25%).¹ Las fracturas de coronoides, condilares y de arco cigomático, pueden enmascarar un fractura de cavidad glenoidea, ya que clínicamente existe restricción de la motricidad mandibular. Presentamos el caso de un paciente de 38 años, con fracturas de complejo cigomaticomaxilar, apófisis coronoides y cavidad glenoidea derecho.

Emergency rooms have seen a gradual increase of patients afflicted by craniofacial fractures. Mandible fractures can be classified according to their anatomical location. The most frequent fractures are angle fractures (36.3%) and body of the mandible fractures (21.2%). Coronoid process fractures are uncommon (0.25%)¹ Zygomatic arch, condylar or coronoid process fractures can mask a fracture of the glenoid fossa, since, clinically, there is restriction of mandibular movements. The case here presented is that of a 38 year patient afflicted with fractures of the maxillary-zygomatic complex, coronoid process as well as right glenoid fossa.

The Operative Treatment of Scapular Glenoid Fracture

PURPOSE: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. MATERIALS AND METHODS: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. RESULTS: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. CONCLUSION: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.