Modified Double‐Row and Double‐Pulley Technique for the Treatment of Type Ia Scapular Glenoid Fractures

• Published in: Orthopaedic surgery Vol. 14; no. 7; pp. 1518 - 1526
• Main Authors: Wang, Yizhong, Li, Qingxian, Zhang, Qingsong
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.07.2022; John Wiley & Sons, Inc; Wiley
• Subjects: Arthritis; Arthroscopic technique; Care and treatment; Cartilage; Double‐row and double‐pulley technique; Fractures; Health aspects; Internal fixation in fractures; Magnetic resonance imaging; Operative Technique; Patients; Scapular glenoid fracture; Surgery; Florida; United States > US; Double-row and double-pulley technique; Scapular glenoid fracture; Arthroscopic technique
• ISSN: 1757-7853; 1757-7861
• DOI: 10.1111/os.13305

Objective To evaluate the efficacy of the double‐row and double‐pulley technique in treating anterior shoulder glenoid fracture (Ideberg type Ia) using shoulder arthroscopy. Methods Thirty‐six patients with Ideberg type Ia admitted from March 1, 2017, to March 1, 2020, were retrospectively reviewed. Data of the patients' history included age, sex, side of the affected arm, the mean time from injury to surgery, the surgical duration, the average blood loss, and the average total duration of hospital stay. The double‐row and double‐pulley technique was used to repair the scapular glenoid fracture under arthroscopy. Computed tomography (CT) was used to evaluate fracture healing after surgery. The American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles (UCLA) shoulder joint scoring system, and the Constant–Murley shoulder function score were used to assess the function of the affected shoulder. Results The surgical duration was 90–150 min, with a mean of 127 min. The average blood loss was 90 mL (range, 60–120 mL), and the average total duration of hospital stay was 9.2 days (range, 3 to 14 days). At 9 months after surgery, the CT results showed that all fractures healed, and all patients returned to their previous levels of activity and regained an excellent range of motion. The visual analog scale (VAS) score was 7.55 ± 1.32 before surgery, and the VAS score significantly decreased to 1.24 ± 0.72 at 12 months after the operation (p < 0.05). The Constant, ASES, and UCLA shoulder function scores were 44.38 ± 2.16, 43.47 ± 12.76, and 21.80 ± 1.16 before the surgery, respectively, which improved to 93.52 ± 2.82, 91.34 ± 8.28, and 33.24 ± 1.64, respectively, in the following 12 months. One patient experienced fat liquefaction. However, no cases of deep venous thrombosis, iatrogenic neurovascular compromise, wound infection, or neurovascular injury were identified. Conclusion The double‐row and double‐pulley technique for treating Ideberg type Ia under shoulder arthroscopy has minor surgical trauma, reliable fracture reduction and fixation, less postoperative pain, and fewer postoperative complications and significantly improves the patient's shoulder joint function. Schematic diagram of double‐row and double‐pulley reduction transverse position of scapula fracture. Scapular glenoid Ideberg type Ia fracture, after the use of arthroscopy to reduce the fracture, two anchors are screwed into the upper and lower fracture of the fracture, and the cross section is fixed with double rows and double pulleys.