Clinical features and treatment of anterior shoulder dislocation complicated with fractures of glenoid and greater tuberosity / 中华创伤骨科杂志

ABSTRACT

Objective:To explore the clinical features and treatment of anterior shoulder dislocation complicated with fractures of glenoid and greater tuberosity (GT).Methods:From December 2013 to October 2019, 26 patients (27 shoulders) were treated at Department of Upper Limb, Sichuan Provincial Orthopaedic Hospital by arthroscopy or open reduction and internal fixation (ORIF). They were 13 males and 13 females with a mean age of 49.1 years (range, from 22 to 71 years). By the Goss-Ideberg classification for glenoid fractures, there were 21 cases of type Ⅰa and 6 cases of type Ⅱ; by the Mutch classification for GT fractures, there were 3 cases of depression type, 6 cases of avulsion type and 18 cases of split type. At the last follow-up, visual analogue scale (VAS), Constant-Murley and American Shoulder & Elbow Surgeons (ASES) scores were used to evaluate the pain and function of the shoulder and the Rowe scores to assess shoulder stability.Results:In this cohort, the avulsion type accounted for 66.7% (18/27) of the GT fractures and the type of anterior glenoid rim for 77.8% (21/27) of the glenoid fractures. All the 26 patients (27 shoulders) were followed up for a mean period of 18.3 months (range, from 12 to 47 months). All fractures united after 6 to 17 weeks (mean, 11.6 weeks). At the last follow-up, anterior flexion and lifting averaged 155.6°, lateral external rotation 43.6°, and the internal rotation thumb touching the spinous process levels from L4 to T8. At the last follow-up, the Constant-Murley scores averaged 89.2, the ASES scores 88.9, the Rowe scores 94.5, and the VAS scores 0.3.Conclusions:In anterior shoulder dislocation complicated with fractures of glenoid and GT, the GT fractures are mainly the split type and the glenoid fractures mainly the type of anterior glenoid rim. Arthroscopy or ORIF can be used to repair rotator cuff tears and restore shoulder stability, leading to significantly improved shoulder function and satisfactory therapeutic outcomes.