背景:本研究的目的是回顾性地比较关节镜下缝合锚钉固定和开放螺钉固定治疗急性巨大前盂缘骨折的临床和放射学结果。
方法:本研究纳入了2013年1月至2020年6月接受关节镜下缝合锚钉固定(A组)或开放式螺钉固定(O组)治疗的急性巨大前盂缘骨折患者,最低随访时间>2年。主观肩值(SSV),美国肩肘外科医师(ASES)评分,Rowe得分,恒定的分数,运动范围(ROM),反复失稳率,并将并发症记录为临床结果。术后复位的质量,重建的关节盂大小,骨折愈合率,和骨关节炎(OA)的进展被评估为放射学结局.
结果:这项回顾性研究包括66例患者,其中A组37例,O组29例,平均随访时间为46.9(范围,24.3-94.2)个月,患者平均年龄46.8(范围,21-69)年。两组的临床结果无显著差异。在两组中都发现了所有平面中的显着ROM限制,并且O组的侧面(ER)的外部旋转(18°vs.10°,P=0.002)。O组还原质量较好(P<0.001)。然而,两组在重建的关节盂大小方面没有显着差异(101.6%±4.6%vs.100.6%±7.1%,P=0.460)和OA进展率(26.9%vs.20%,P=0.525)。
结论:关节镜下缝合锚钉固定和开放螺钉固定获得了相似的临床结果,重建的关节盂大小,急性巨大前盂缘骨折患者的OA进展。关节镜下缝线固定显示复位质量较差,但ERs局限性较小。
BACKGROUND: The purpose of the present study was to retrospectively compare the clinical and radiological outcomes of arthroscopic suture anchor fixation and open screw fixation for acute large anterior glenoid rim fractures.
METHODS: This study enrolled patients with acute large anterior glenoid rim fractures treated with arthroscopic suture anchor fixation (group A) or open screw fixation (group O) from January 2013 to June 2020 with a minimum follow-up of>2 years. The Subjective Shoulder Value (SSV), American Shoulder and Elbow Surgeons (ASES) score, Rowe score, Constant score, range of motion (ROM), recurrent instability rate, and complications were recorded as clinical results. The quality of the postoperative reduction, reconstructed glenoid sizes, rate of fracture healing, and progression of osteoarthritis (OA) were evaluated as radiological outcomes.
RESULTS: This retrospective study included 66 patients, including 37 in Group A and 29 in Group O with a mean follow-up of 46.9 (range, 24.3-94.2) months and a mean patient age of 46.8 (range, 21-69) years. No significant differences were found in the clinical outcomes between the two groups. A significant ROM limitation in all planes was found in both groups and group O showed more limitations in external rotation at the side (ERs) (18° vs. 10°, P = 0.002). The reduction quality was better in group O (P < 0.001). However, there was no significant difference between the two groups in terms of reconstructed glenoid size (101.6% ± 4.6% vs. 100.6% ± 7.1%, P = 0.460) and the rate of OA progression (26.9% vs. 20%, P = 0.525).
CONCLUSIONS: Arthroscopic suture anchor fixation and open screw fixation achieved similar clinical outcomes, reconstructed glenoid sizes, and OA progression in patients with acute large anterior glenoid rim fractures. Arthroscopic suture fixation showed a poorer quality of reduction but less ERs limitations.