Minimally Invasive Surgery of Glenoid Fractures

Abstract

Patients and Methods: In five men, aged between 23 and 57 years, displaced glenoid fractures were reduced and stabilized arthroscopically or arthroscopically assisted. Fractures were diagnosed by trauma series X-rays completed by computed tomography to record the extent of intraarticular displacement. Two anterior rim fractures were classified as Ideberg type I, one fracture as type II, and two fractures as type III. Type I fractures were reattached arthroscopically after evidence of an adherent labrum-ligament complex with suture anchors inserted distal and proximal to the fracture line. Type II and type III fractures could be reduced by means of two K-wires placed percutaneously in the distal fragment. K-wires were drilled forward after closed reduction. Transcutaneous screw fixation with (cannulated) cortex screws was controlled arthroscopically. Fixation with suture anchor limited postoperative physiotherapy to passive motion during 6 weeks, whereas protected active exercises were possible after the 1st postoperative day following screw fixation.

Results: Using the Rowe score, long-term results (mean observation time: 26 months) were good or excellent (mean: 95/100, range: 85–100/100).

Conclusion: Minimally invasive surgery of glenoid fractures can be performed successfully in Bankart lesions as well as in more complex glenoid fractures.