Arthroscopic suture anchor fixation results in similar clinical outcomes, less range of motion limitation, but poorer quality of reduction compared to open screw fixation for acute large anterior glenoid rim fractures

IF 2.9 2区医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2024-08-24 DOI:10.1016/j.jse.2024.07.013

Di Wu MD , Guangcheng Zhang MD , Zhekun Zhou MD , Wei Song MD , Daoyun Chen MD , Zhenlong Bai MD , Weilin Yu MD , Yaohua He MD

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Abstract

Background

The purpose of the present study was to retrospectively compare the clinical and radiologic outcomes of arthroscopic suture anchor fixation and open screw fixation for acute large anterior glenoid rim fractures.

Methods

This study enrolled patients with acute large anterior glenoid rim fractures treated with arthroscopic suture anchor fixation (group A) or open screw fixation (group O) from January 2013 to June 2020 with a minimum follow-up of＞2 years. The Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, Rowe score, Constant score, range of motion, recurrent instability rate, and complications were recorded as clinical results. The quality of the postoperative reduction, reconstructed glenoid sizes, rate of fracture healing, and progression of osteoarthritis (OA) were evaluated as radiologic outcomes.

Results

This retrospective study included 66 patients, including 37 in Group A and 29 in Group O with a mean follow-up of 46.9 (range: 24.3-94.2) months and a mean patient age of 46.8 (range: 21-69) years. No significant differences were found in the clinical outcomes between the two groups. A significant range of motion limitation in all planes was found in both groups and group O showed more limitations in external rotation at the side (18° vs. 10°, P = .002). The reduction quality was better in group O (P < .001). However, there was no significant difference between the two groups in terms of reconstructed glenoid size (101.6% ± 4.6% vs. 100.6% ± 7.1%, P = .460) and the rate of OA progression (26.9% vs. 20%, P = .525).

Conclusion

Arthroscopic suture anchor fixation and open screw fixation achieved similar clinical outcomes, reconstructed glenoid sizes, and OA progression in patients with acute large anterior glenoid rim fractures. Arthroscopic suture fixation showed a poorer quality of reduction but less external rotation at the side limitations.

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关节镜下缝合锚固定术与开放式螺钉固定术治疗急性大型盂前缘骨折的临床疗效相似，活动范围限制较少，但复位质量较差。

研究背景本研究旨在回顾性比较关节镜下缝合锚固定和开放螺钉固定治疗急性大型盂前缘骨折的临床和放射学结果：本研究选取了2013年1月至2020年6月期间接受关节镜下缝合锚固定（A组）或开放螺钉固定（O组）治疗的急性大面积盂前缘骨折患者，随访时间至少＞2年。临床结果包括肩部主观值（SSV）、美国肩肘外科医生（ASES）评分、Rowe评分、Constant评分、活动范围（ROM）、复发不稳定性率和并发症。术后缩小的质量、重建的盂大小、骨折愈合率和骨关节炎（OA）的进展作为放射学结果进行评估：这项回顾性研究共纳入66名患者，其中A组37人，O组29人，平均随访时间为46.9个月（24.3-94.2个月），平均年龄为46.8岁（21-69岁）。两组患者的临床结果无明显差异。两组患者在所有平面上的活动度均明显受限，而 O 组患者在侧方外旋（ER）方面受限更多（18° vs. 10°，P = 0.002）。O 组的还原质量更好（P < 0.001）。然而，就重建后的盂骨大小（101.6% ± 4.6% vs. 100.6% ± 7.1%，P = 0.460）和OA进展率（26.9% vs. 20%，P = 0.525）而言，两组间无明显差异：结论：关节镜下缝合锚固定和开放螺钉固定在急性大面积盂前缘骨折患者中取得了相似的临床效果、重建的盂大小和OA进展。关节镜下缝合固定的复位质量较差，但ERs限制较少。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.