Treatment of Ideberg type <b>Ⅱ</b> scapular glenoid fracture with compression screw combined with Buttress plate through direct axillary approach_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Jianping , LIU Hui , XU Weizhen , XIONG Yuanfei , ZHANG Jinhui ,  WU Jin

Department of Orthopaedics, Joint Support Force 909th Hospital of Chinese PLA, Southeast Hospital of Xiamen University, Zhangzhou Fujian, 363000,P. R. China;

Corresponding author：

WU Jin, Email: wujin1983@xmu.edu.cn

Keywords：

Scapular glenoid fracture; axillary approach; Ideberg classification; compression screw; Buttress plate; internal fixation

DOI：

10.7507/1002-1892.202308005

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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.

Citation： ZHANG Jianping, LIU Hui, XU Weizhen, XIONG Yuanfei, ZHANG Jinhui, WU Jin. Treatment of Ideberg type Ⅱ scapular glenoid fracture with compression screw combined with Buttress plate through direct axillary approach. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(11): 1375-1379. doi: 10.7507/1002-1892.202308005 Copy

1.	Hu Y, Shi H, Wang F, et al. Functional outcomes of extra-articular scapula fracture fixation with distal humeral Y-type locking plate: a retrospective study. J Orthop Surg Res, 2019, 14(1): 176.
2.	Tucek M, Chochola A, Klika D, et al. Epidemiology of scapular fractures. Acta Orthop Belg, 2017, 83(1): 8-15.
3.	涂学招, 米萌, 查晔军, 等. 经肩胛下肌入路治疗IdebergⅠa型肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(2): 132-137.
4.	严亮, 蔡强强, 赵红阳, 等. 经腋窝入路治疗肩胛盂骨折. 临床骨科杂志, 2022, 25(4): 605.
5.	Bartoníček J, Naňka O. History of diagnostics and treatment of scapular fractures in children and adolescents and its clinical importance. Arch Orthop Trauma Surg, 2022, 142(6): 1067-1074.
6.	Tucker A, Donnelly K, Murphy L, et al. Percutaneous arthroscopic-assisted glenoid fixation: A novel surgical technique. J Orthop Case Rep, 2018, 8(4): 3-6.
7.	Park JK, Jeong HS. Clinical and radiologic outcomes of open reduction and internal fixation without capsular incision for inferior glenoid fossa fractures. Clin Orthop Surg, 2023, 15(2): 175-181.
8.	Seidl AJ, Joyce CD. Acute fractures of the glenoid. J Am Acad Orthop Surg, 2020, 28(22): e978-e987.
9.	Ström P. Glenoid fractures of the shoulder. EFORT Open Rev, 2020, 5(10): 620-623.
10.	Königshausen M, Coulibaly MO, Nicolas V, et al. Results of non-operative treatment of fractures of the glenoid fossa. Bone Joint J, 2016, 98-B(8): 1074-1079.
11.	Frich LH, Larsen MS. How to deal with a glenoid fracture. EFORT Open Rev, 2017, 2(5): 151-157.
12.	Fandridis E, Anastasopoulos PP, Alexiadis G, et al. Posterior subdeltoid and external rotators preserving approach for reduction and fixation of displaced extra-articular fractures of the scapula. Eur J Orthop Surg Traumatol, 2018, 28(4): 585-591.
13.	Tatro JM, Gilbertson JA, Schroder LK, et al. Five to ten-year outcomes of operatively treated scapular fractures. J Bone Joint Surg (Am), 2018, 100(10): 871-878.
14.	Limb D. Scapula fractures: a review. EFORT Open Rev, 2021, 6(6): 518-525.
15.	Pires RE, Giordano V, de Souza FSM, et al. Current challenges and controversies in the management of scapular fractures: a review. Patient Saf Surg, 2021, 15(1): 6.
16.	米萌, 黄东宁, 杨凯星, 等. 采用改良Judet入路治疗肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2021, 23(11): 991-994.
17.	吴义刚, 李银山, 吴鹏, 等. 后侧入路微创内固定治疗不稳定肩胛骨骨折的疗效. 中华创伤杂志, 2018, 34(5): 415-419.
18.	杨栋, 把小荣, 张晨鹏. 肩胛骨外侧缘入路及Judet入路治疗肩胛骨骨折的对照研究. 创伤外科杂志, 2020, 22(11): 836-839.
19.	张子言, 邢永, 丁坚, 等. 腋窝后缘入路治疗部分肩胛骨骨折的初步疗效分析. 中华创伤骨科杂志, 2022, 24(5): 414-420.
20.	邢永, 张子言, 郭琰, 等. 腋窝入路肩胛盂前缘骨折复位固定的应用解剖学及临床研究. 中华骨科杂志, 2022, 42(1): 18-25.
21.	王锟, 公茂琪, 王爱国, 等. 经腋窝入路治疗肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(8): 687-692.
22.	姜刚强, 焦福德, 虞天明, 等. 经腋窝入路内固定治疗Ideberg Ⅰ、Ⅱ型肩胛骨骨折疗效观察. 中国骨与关节损伤杂志, 2023, 38(1): 71-73.
23.	Ding H, Bao YG, Yin B, et al. Efficacy analysis of axillary approach in the treatment of Ideberg type Ⅰ and Ⅱ scapular glenoid fractures: Case series. Medicine (Baltimore), 2023, 102(28): e34333.

1. Hu Y, Shi H, Wang F, et al. Functional outcomes of extra-articular scapula fracture fixation with distal humeral Y-type locking plate: a retrospective study. J Orthop Surg Res, 2019, 14(1): 176.
2. Tucek M, Chochola A, Klika D, et al. Epidemiology of scapular fractures. Acta Orthop Belg, 2017, 83(1): 8-15.
3. 涂学招, 米萌, 查晔军, 等. 经肩胛下肌入路治疗IdebergⅠa型肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(2): 132-137.
4. 严亮, 蔡强强, 赵红阳, 等. 经腋窝入路治疗肩胛盂骨折. 临床骨科杂志, 2022, 25(4): 605.
5. Bartoníček J, Naňka O. History of diagnostics and treatment of scapular fractures in children and adolescents and its clinical importance. Arch Orthop Trauma Surg, 2022, 142(6): 1067-1074.
6. Tucker A, Donnelly K, Murphy L, et al. Percutaneous arthroscopic-assisted glenoid fixation: A novel surgical technique. J Orthop Case Rep, 2018, 8(4): 3-6.
7. Park JK, Jeong HS. Clinical and radiologic outcomes of open reduction and internal fixation without capsular incision for inferior glenoid fossa fractures. Clin Orthop Surg, 2023, 15(2): 175-181.
8. Seidl AJ, Joyce CD. Acute fractures of the glenoid. J Am Acad Orthop Surg, 2020, 28(22): e978-e987.
9. Ström P. Glenoid fractures of the shoulder. EFORT Open Rev, 2020, 5(10): 620-623.
10. Königshausen M, Coulibaly MO, Nicolas V, et al. Results of non-operative treatment of fractures of the glenoid fossa. Bone Joint J, 2016, 98-B(8): 1074-1079.
11. Frich LH, Larsen MS. How to deal with a glenoid fracture. EFORT Open Rev, 2017, 2(5): 151-157.
12. Fandridis E, Anastasopoulos PP, Alexiadis G, et al. Posterior subdeltoid and external rotators preserving approach for reduction and fixation of displaced extra-articular fractures of the scapula. Eur J Orthop Surg Traumatol, 2018, 28(4): 585-591.
13. Tatro JM, Gilbertson JA, Schroder LK, et al. Five to ten-year outcomes of operatively treated scapular fractures. J Bone Joint Surg (Am), 2018, 100(10): 871-878.
14. Limb D. Scapula fractures: a review. EFORT Open Rev, 2021, 6(6): 518-525.
15. Pires RE, Giordano V, de Souza FSM, et al. Current challenges and controversies in the management of scapular fractures: a review. Patient Saf Surg, 2021, 15(1): 6.
16. 米萌, 黄东宁, 杨凯星, 等. 采用改良Judet入路治疗肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2021, 23(11): 991-994.
17. 吴义刚, 李银山, 吴鹏, 等. 后侧入路微创内固定治疗不稳定肩胛骨骨折的疗效. 中华创伤杂志, 2018, 34(5): 415-419.
18. 杨栋, 把小荣, 张晨鹏. 肩胛骨外侧缘入路及Judet入路治疗肩胛骨骨折的对照研究. 创伤外科杂志, 2020, 22(11): 836-839.
19. 张子言, 邢永, 丁坚, 等. 腋窝后缘入路治疗部分肩胛骨骨折的初步疗效分析. 中华创伤骨科杂志, 2022, 24(5): 414-420.
20. 邢永, 张子言, 郭琰, 等. 腋窝入路肩胛盂前缘骨折复位固定的应用解剖学及临床研究. 中华骨科杂志, 2022, 42(1): 18-25.
21. 王锟, 公茂琪, 王爱国, 等. 经腋窝入路治疗肩胛盂骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(8): 687-692.
22. 姜刚强, 焦福德, 虞天明, 等. 经腋窝入路内固定治疗Ideberg Ⅰ、Ⅱ型肩胛骨骨折疗效观察. 中国骨与关节损伤杂志, 2023, 38(1): 71-73.
23. Ding H, Bao YG, Yin B, et al. Efficacy analysis of axillary approach in the treatment of Ideberg type Ⅰ and Ⅱ scapular glenoid fractures: Case series. Medicine (Baltimore), 2023, 102(28): e34333.

Chinese Journal of Reparative and Reconstructive Surgery

Treatment of Ideberg type Ⅱ scapular glenoid fracture with compression screw combined with Buttress plate through direct axillary approach

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