OP-Journal 2022; 38(03): 218-226
DOI: 10.1055/a-1757-7221
Fachwissen

Glenoidfraktur

Glenoidal Fracture
Till Orla Klatte
,
Konrad Mader
,
Karl-Heinz Frosch

Zusammenfassung

Glenoidfrakturen stellen im klinischen Alltag eine Rarität da. Neben hochenergetischen Traumata finden sich häufig Luxationsereignisse als Ursache. Nicht nur die Frakturmorphologie, sondern auch das zugrunde liegende Trauma haben einen Einfluss auf die richtige Entscheidung für die weitere konservative oder operative Behandlung. Insbesondere für größere anteriore Glenoidfrakturen zeigt die aktuelle Literatur gute Ergebnisse für die konservative Behandlung. Hingegen zeigen kleinere Bony-Bankart-Verletzungen eine höhere Instabilitätsrate beim jungen Patienten unter konservativer Therapie. Für die operativen Versorgungstechniken bieten sich zunehmend, neben offenen Verfahren, eine Reihe arthroskopischer Techniken an.

Abstract

Glenoid fractures are a rarity in clinical practice. In addition to high-energy traumata, dislocation events are often found as the cause. Not only the fracture morphology but also the underlying trauma have an influence on the right decision for further conservative or surgical treatment. Especially for larger anterior glenoid fracture the current literature shows good results for conservative treatment. In contrast, smaller bony Bankart injuries show a higher instability rate in the young patient under conservative therapy. For surgical treatment techniques, a number of arthroscopic techniques are increasingly available in addition to open procedures.



Publication History

Article published online:
27 September 2022

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  • Literatur

  • 1 van Oostveen DPH, Temmerman OPP, Burger BJ. et al. M. Glenoid fractures: a review of pathology, classification, treatment and results. Acta Orthop Belg 2014; 80: 88-98
  • 2 Gilbert F, Eden L, Meffert R. et al. Intra- and interobserver reliability of glenoid fracture classifications by Ideberg, Euler and AO. BMC Musculoskelet Disord 2018; 19: 89
  • 3 Frich LH, Larsen MS. How to deal with a glenoid fracture. EFORT Open Rev 2017; 2: 151-157
  • 4 Piponov HI, Savin D, Shah N. et al. Glenoid version and size: does gender, ethnicity, or body size play a role?. Int Orthop 2016; 40: 2347-2353
  • 5 Gottschalk HP, Browne RH, Starr AJ. Shoulder Girdle: Patterns of Trauma and Associated Injuries. J Orthop Trauma 2011; 25: 266-271
  • 6 ter Meulen DP, Janssen SJ, Hageman MGJS. et al. Quantitative three-dimensional computed tomography analysis of glenoid fracture patterns according to the AO/OTA classification. J Shoulder Elbow Surg 2016; 25: 269-275
  • 7 Hovelius L. Anterior dislocation of the shoulder in teen-agers and young adults. Five-year prognosis. J Bone Joint Surg Am 1987; 69: 393-399
  • 8 Kelly MJ, Holton AE, Cassar-Gheiti AJ. et al. The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries: a systematic review. Bone Joint J 2019; 101-B: 15-21
  • 9 Wiedeman E. Frakturen der Skapula. Unfallchirurg 2004; 107: 1124-1133
  • 10 Van Oostveen DP, Temmermann OP, Verberne SJ. et al. Inter- And Intraobserver Reliability In The Assessment Of Glenoid Fracture Classifications. Acta Orthop Belg 2017; 83: 605-611
  • 11 Harvey E, Audigé L, Herscovici D. et al. Development and Validation of the New International Classification for Scapula Fractures. J Orthop Trauma 2012; 26: 364-369
  • 12 Goss TP. Fractures of the glenoid neck. J Shoulder Elbow Surg 1994; 3: 42-52
  • 13 Schroder LK, Gauger EM, Gilbertson JA. et al. Functional Outcomes After Operative Management of Extra-Articular Glenoid Neck and Scapular Body Fractures. J Bone Joint Surg 2016; 98: 1623-1630
  • 14 Königshausen M, Pätzholz S, Coulibaly M. et al. Instability and results after non-operative treatment of large anterior glenoid rim fractures: is there a correlation between fragment size or displacement and recurrence. Arch Orthop Trauma Surg 2021;
  • 15 Wieser K, Waltenspül M, Ernstbrunner L. et al. Nonoperative Treatment of Anterior Glenoid Rim Fractures After First-Time Traumatic Anterior Shoulder Dislocation: A Study with 9-Year Follow-up. JB JS Open Access 2020; 5: e20.00133
  • 16 Spiegl UJA, Ryf C, Hepp P. et al. Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up. BMC Musculoskelet Disord 2013; 14: 305
  • 17 Nakagawa S, Hirose T, Uchida R. et al. A Glenoid Defect of 13.5% or Larger Is Not Always Critical in Male Competitive Rugby and American Football Players Undergoing Arthroscopic Bony Bankart Repair: Contribution of Resultant Large Bone Fragment. Arthroscopy 2022; 38: 673-681
  • 18 Nakagawa S, Hirose T, Uchida R. et al. Remaining Large Bone Fragment of a Bony Bankart Lesion in Shoulders With a Subcritical Glenoid Defect: Association With Recurrent Anterior Instability. Am J Sports Med 2022; 50: 189-194
  • 19 Bonnevialle N, Clavert P, Arboucalot M. et al. Contribution of arthroscopy in the treatment of anterior glenoid rim fractures: a comparison with open surgery. J Shoulder Elbow Surg 2019; 28: 42-47
  • 20 Tauber M, Moursy M, Eppel M. et al. Arthroscopic screw fixation of large anterior glenoid fractures. Knee Surg Sports Traumatol Arthrosc 2008; 16: 326-332
  • 21 Wafaisade A, Pfeiffer TR, Balke M. et al. Arthroscopic Transosseous Suture Button Fixation Technique for Treatment of Large Anterior Glenoid Fracture. Arthrosc Tech 2019; 8: e1319-e1326
  • 22 Scheibel M, Hug K, Gerhardt C. et al. Arthroscopic reduction and fixation of large solitary and multifragmented anterior glenoid rim fractures. J. Shoulder Elbow Surg 2016; 25: 781-790
  • 23 Millett PJ, Braun S. The „bony Bankart bridge“ procedure: a new arthroscopic technique for reduction and internal fixation of a bony Bankart lesion. Arthroscopy 2009; 25: 102-105
  • 24 Greenstein AS, Chen RE, Brown AM. et al. Chondral Damage After Arthroscopic Repair Techniques for Acute Bony Bankart Lesions: A Biomechanical Study. Am J Sports Med 2021; 49: 2743-2750
  • 25 Kowalsky MS, Levine WN. Traumatic Posterior Glenohumeral Dislocation: Classification, Pathoanatomy, Diagnosis, and Treatment. Orthop Clin North Am 2008; 39: 519-533
  • 26 Nacca C, Gil JA, Badida R. et al. Critical Glenoid Bone Loss in Posterior Shoulder Instability. Am J Sports Med 2018; 46: 1058-1063
  • 27 Lacheta L, Goldenberg BT, Horan MP. et al. Posterior bony Bankart bridge technique results in reliable clinical 2-year outcomes and high return to sports rate for the treatment of posterior bony Bankart lesions. Knee Surg Sports Traumatol Arthrosc 2021; 29: 120-126
  • 28 Brodsky JW, Tullos HS, Gartsman GM. Simplified posterior approach to the shoulder joint. A technical note. J Bone Joint Surg Am 1987; 69: 773-774
  • 29 Fandridis E, Anastasopoulos PP, Alexiadis G. et al. Posterior subdeltoid and external rotators preserving approach for reduction and fixation of displaced extra-articular fractures of the scapula. Eur J Orthop Surg Traumatol 2018; 28: 585-591
  • 30 Goss TP. Double Disruptions of the Superior Shoulder Suspensory Complex. J Orthop Trauma 1993; 7: 99-106
  • 31 Mayo KA, Benirschke SK, Mast JW. Displaced fractures of the glenoid fossa. Results of open reduction and internal fixation. 1998; (347) 122-130
  • 32 Cole PA, Gauger EM, Herrera DA. et al. Radiographic follow-up of 84 operatively treated scapula neck and body fractures. Injury 2012; 43: 327-333
  • 33 Ao R, Jian Z, Zhou J. et al. A comparison of deltopectoral versus Judet approach for glenoid exposure. J Shoulder Elbow Surg 2020; 29: 370-373