Ideberg Type Research Articles

Acromial approach for treating glenoid fractures: A report of two cases and a literature review.

Surgery is usually recommended for displaced glenoid fractures, with open reduction and internal fixation as the standard operative treatment. Three approaches have been recommended in the reduction of glenoid fractures: Anterior, posterior and combined; however, a traditional approach may be difficult due to a high position or a comminuted Ideberg type III fracture. The combined approach results in a longer incision and more soft tissue injury when associated with an acromial fracture. The present study describes two complicated glenoid fractures: One case was a comminuted Ideberg type III fracture associated with an Ogawa type II acromial fracture; the second case was an Ideberg type IV fracture with associated superior shoulder suspensory complex injuries. In these cases, the acromial approach was modified to achieve satisfactory exposure and fixation of the complicated fracture. After a 1-year follow-up, the patients had a satisfactory outcome.

Arthroscopic-Assisted Fixation of Ideberg Type III Glenoid Fractures

Operative treatment of scapular fractures with extension into the glenoid can be a challenging clinical scenario. Though traditionally addressed in an open fashion, the morbidity of this approach, complemented by advancements in arthroscopic technique and instrumentation, has led to increasing use of arthroscopic-assisted fixation. We describe our technique, including pearls and pitfalls, for minimally invasive fixation of Ideberg type III glenoid fractures. This approach minimizes morbidity, allows optimal visualization and reduction, and provides good functional results.

肩甲骨関節窩骨折Ideberg type 4 に対し関節鏡補助下に整復固定を行った 1 例

肩甲骨関節窩骨折Ideberg type 4 に対し関節鏡補助下に整復固定を行った 1 例

鏡視下骨接合術を施行した肩甲骨関節窩骨折 Ideberg typeIII の 1 例

鏡視下骨接合術を施行した肩甲骨関節窩骨折 Ideberg typeIII の 1 例

Surgical Treatment of Ideberg Type III Glenoid Fractures With Associated Superior Shoulder Suspensory Complex Injury

Ideberg type III glenoid fractures with associated superior shoulder suspensory complex (SSSC) injuries are rare, and related treatments have not been reported in the literature. The purpose of this study was to evaluate the clinical outcomes of such injuries treated with open reduction and internal fixation (ORIF). Between July 2007 and April 2012, ten patients with Ideberg type III glenoid fractures were surgically treated using ORIF with 2 cannulated screws or a screw combined with a metacarpal plate through an anterior approach. Patients with associated SSSC injuries underwent ORIF with K-wires or plates. Information was available for 9 patients with a mean follow-up of 24.1±18.2 months. Mean bone-healing time was 8.4±2.2 weeks. At last follow-up, mean forward flexion of the operative shoulder was 157.8°±7.5°, mean external rotation was 62.9°±7.9°, and mean internal rotation was thoracic level T6±0.8. Mean Constant score was 84.1±3.7 points, which was a mean of 92.7%±3.4% of that seen in the contralateral shoulder. Mean UCLA score and Disabilities of the Arm, Shoulder and Hand score were 33.6±1.7 and 16.6±7.7, respectively. The results show that Ideberg type III glenoid fractures with associated SSSC injuries can be successfully treated using ORIF through an anterior approach. Glenoid fractures and SCCC injuries should be treated simultaneously.

Floating Shoulder: Ipsilateral Clavicle, Scapular Body And Glenoid Fracture. A Case Report

We present a case of shoulder instability following a traffic accident. Allman Type I midshaft clavicle, Ideberg Type II glenoid and DeCloux Type I scapular body fractures were diagnosed following radiologic examination. There were no signs of ligamentous injury. Mechanical instability was noted at the shoulder due to breakage of the supportive bony skeleton. The patient was treated surgically with plate and screw fixation. Surgical fixation allowed early postoperative physiotherapy and rehabilitation. This rare injury and its treatment options are discussed in the light of current literature. floating shoulder, scapula, clavicle, glenoid, mechanical instability.

Results and Functional Outcome of Arthroscopically-assisted Fixation of Glenoid Fractures: Three Cases

Severely displaced glenoid fractures require open reduction and internal fixation to avoid chronic instability or degenerative changes. Arthroscopic techniques potentially facilitate accurate fracture reduction and fixation without the need for extensive surgical dissection. We report three male patients (mean age 26 years; range 17 years to 40 years) who underwent arthroscopically-assisted reduction and internal fixation for a displaced Ideberg type III (two cases) or IV glenoid (one case) fracture. Cannulated, partially-threaded screws were inserted percutaneously via a superior approach just anterior to the clavicle in all cases. Patients were assessed postoperatively with serial radiographs and clinically using the Constant–Murley shoulder score (0 points to 100 points) at 1 year. There were no recorded complications of surgery, and all fractures united within 3 months. At 6 months, all patients returned to their previous levels of activity and regained an excellent range of motion. The mean Constant–Murley shoulder score at 1 year was 95 points (range 94 to 96), and there was no radiological evidence of arthrosis. Arthroscopic fixation of transverse-orientated glenoid fractures can have excellent functional results, and percutaneous screw insertion via a superior approach appears to be a safe and reproducible technique.

Arthroscopic-Assisted Reduction and Percutaneous Cannulated Screw Fixation for Ideberg Type III Glenoid Fractures

Background: Traditionally, open reduction and internal fixation is an acceptable choice for treating displaced glenoid articular fracture. Considering some major complications associated with open surgery, however, surgeons have explored a less invasive way to achieve fixation. Purpose: This investigation was undertaken to evaluate the clinical results of arthroscopic-assisted reduction and percutaneous cannulated screw fixation for the treatment of Ideberg type III glenoid fractures. Study Design: Case series; Level of evidence, 4. Methods: Twenty-three consecutive patients with Ideberg type III glenoid fractures underwent arthroscopic-assisted reduction and percutaneous cannulated screw fixation. Eighteen patients (78.3%) were available for the final follow-up, at a mean of 37.6 months (range, 24-61 months). There were 12 men and 6 women, with an average age of 41.2 years (range, 22-62 years). Dominant sides were involved in 10 patients. The mean time from injury to surgery was 5.9 ± 2.7 days. Results: The average ranges of motion of the affected shoulders at the final follow-up were 162.8° ± 8.3° in forward elevation, 67.2° ± 4.6° in external rotation at the side, and T8 ± 2 in internal rotation. The average visual analog scale pain score was 0.7 ± 0.9 (range, 0-3), the average American Shoulder and Elbow Surgeons score was 96.0 ± 5.4 (range, 80-100), the average Constant-Murley score was 96.8 ± 2.9 (range, 90-100), and the average University of California, Los Angeles, score was 34.3 ± 0.9 (range, 33-35). No hardware failure or redisplacement of the fracture occurred, and all fractures healed without any major complication associated with the surgery. Conclusion: Arthroscopic-assisted reduction and percutaneous cannulated screw fixation is a safe and effective method for the treatment of Ideberg type III glenoid fractures.

견갑골 관절와 골절의 수술적 치료

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam`s functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

Minimally Invasive Surgery of Glenoid Fractures

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.