Open fixation of acute anterior glenoid rim fractures with bioresorbable pins: analysis of clinical and radiological outcome.

Abstract

The purpose of this study was a detailed analysis of clinical and radiological results following open fixation of acute-traumatic, displaced anterior glenoid rim fractures with bioresorbable pins. This retrospective study included 17 patients with glenoid defect sizes ≥20%, as directly measured in preoperative sagittal en face CT. The mean glenoid defect size was 25.3% (20-35, SD 4.7). Two or three polylactid pins were used for fixation. Mean age of patients at the time of surgery was 50.1years (27-71). The mean follow-up period was 6.2years (2.0-11.1). Follow-up included comprehensive objective and subjective evaluation of shoulder function as well as standard radiographs. The majority of 15/17 patients obtained good or excellent clinical results according to the absolute and normalized Constant score, the Rowe score, the Oxford shoulder score, the simple shoulder test, the shoulder pain and disability index and the subjective shoulder value. Quality of life (SF-36) showed reference values. Mean or subitem values of all outcome measures did not differ from the contralateral, uninjured side. Radiographically, all fractures healed without secondary dislocation. Radiological signs of glenohumeral arthritis developed in two patients and progressed in two other patients. There were no implant-related complications. No patient experienced glenohumeral instability or had to undergo revision surgery. Bioresorbable pin fixation is a feasible and safe method of osteosynthesis for anterior glenoid rim fractures up to a glenoid defect size of about 35% and enables immediate active range of motion. Good or excellent clinical outcome can be expected and glenohumeral stability is reliably restored. The most common mid- and long-term complication is occurrence or progression of osteoarthritis. The major benefits of bioresorbable pin fixation are redundancy of implant removal, minimal risk of implant-related complications and early functional rehabilitation.