Arthroscopic screw fixation of large anterior glenoid fractures

Abstract

Ten patients after traumatic shoulder dislocation with resulting instability due to an acute anterior glenoid fracture involving at least 21 percent of the glenoid length were treated by arthroscopic screw fixation of the fragment. The average fragment size measured 26.2% of the glenoid length. Pre- and postoperative radiographic evaluations were performed with three-dimensional CT scans. A cannulated titanium screw system was used for fragment fixation. All ten patients were followed up radiographically and, by evaluation of the Rowe score, clinically after a minimum of 2 years. At follow-up the Rowe score averaged 94 points. According to the rating scale, seven patients had an excellent result, two patients a good result, and one, fair result. In all patients CT scan confirmed that the fracture had healed in an anatomical position. One patient had one episode of traumatic redislocation with a positive apprehension test at follow up. In one case, removal of the screw was necessary due to mechanical impingement. We recommend this arthroscopic technique allowing for closed reduction and internal screw fixation of large anterior glenoid fractures, ensuring anatomical fracture healing and gleno-humeral joint stability.