Clin Orthop Surg.  2023 Apr;15(2):175-181. 10.4055/cios22183.

Clinical and Radiologic Outcomes of Open Reduction and Internal Fixation without Capsular Incision for Inferior Glenoid Fossa Fractures

• Park JK
• Jeong HS

• KMID: 2540435
• DOI: http://doi.org/10.4055/cios22183

Abstract

Background
Scapular surgery is usually undertaken via the posterior approach described by Judet. This approach allows access to the entire posterior scapular body; however, it results in severe soft-tissue injury and requires an incision in the deltoid muscle. To date, no clinical study has been reported on open reduction and internal fixation without capsular incision for displaced inferior glenoid fractures (Ideberg type II). The purpose of this study was to introduce an easy and less invasive approach to the inferior glenoid fossa and evaluate its clinical outcomes.
Methods
Ten patients with displaced inferior glenoid fractures underwent open reduction and internal fixation without capsular incision between January 2017 and July 2018. Postoperative computed tomography was performed to evaluate the reduction state within a week of the surgery. Clinical and radiological data from 7 patients who were followed up for more than 2 years were analyzed.
Results
The mean age of the patients was 61.7 years (range, 35–87 years). The mean follow-up period was 28.6 months (range, 24–42 months). The mean preoperative fracture gap and step-off values were 12.3 ± 4.4 mm and 6.8 ± 4.0 mm, respectively. Surgical stabilization was conducted 6.4 days (range, 4–13 days) after trauma. Mean postoperative-preoperative fracture gap and stepoff values were 0.6 ± 0.6 mm and 0.6 ± 0.8 mm, respectively. At 24 months after surgery, the mean Constant score was 89.1 ± 10.6 points (range, 69–100) and the mean pain visual analog scale score was 1.4 ± 1.7 (range, 0–5). Bony union was observed in all patients. The mean time to bony union was 11 ± 1.7 weeks. The mean active range values for forward elevation, external rotation, and abduction were 162.9° ± 11.1° (range, 150°–180°), 55.7° ± 15.1° (range, 30°–70°), and 158.6° ± 10.7° (range, 150°–180°), respectively.
Conclusions
The presented posterior open reduction and internal fixation without capsular incision or extensive soft-tissue dissection may be an easy and less invasive surgical approach for inferior glenoid fossa fractures (Ideberg type II).

Keyword

Scapula; Glenoid cavity; Fracture; Operative procedure