Nejvíce citovaný článek - PubMed ID 3791738
INTRODUCTION: A typical feature of inferior glenoid fractures is a distal fragment separated from the glenoid fossa. In most cases, the inferior glenoid fractures are associated with a fracture of the scapular body. However, there are no detailed studies of inferior glenoid fractures, and only brief mentions can be found in the literature in this respect. MATERIAL AND METHODS: The basic group comprised 42 patients, with the mean age of 48 years, who sustained 42 fractures of the inferior glenoid. In this group, the scapular fracture anatomy was evaluated, based on 3D CT reconstructions. A total of 29 patients operated on were followed up for 12 to 128 months after injury (average, 52 months), three patients were lost to follow up. The results of the operative treatment, including complications, were assessed radiologically and functionally. RESULTS: Fracture anatomy was described from various aspects, i.e., the size of the articular surface carried by the separated glenoid fragment, the existence of multiple articular fragments, the size of the separated glenoid fragment and the extent of injury to the scapular body. All 29 operatively treated fractures radiologically healed within three months. Full and pain-free range of motion was restored in 18 patients; in eight patients it was limited by 20 degrees and in three patients by more than 40 degrees. The mean Constant score was 82. CONCLUSION: Fractures of the inferior glenoid fossa requires CT examination, including 3D CT reconstruction with subtraction of the surrounding bones. Displaced fractures are indicated for operative treatment.
- Klíčová slova
- Glenoid fossa fractures, Inferior glenoid, Operative treatment, Scapular fractures,
- MeSH
- dospělí MeSH
- fraktury proximálního humeru diagnostické zobrazování chirurgie MeSH
- kloubní jamka lopatky diagnostické zobrazování zranění chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- počítačová rentgenová tomografie metody MeSH
- retrospektivní studie MeSH
- rozsah kloubních pohybů MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vnitřní fixace fraktury škodlivé účinky metody MeSH
- zobrazování trojrozměrné metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Fractures of the scapular, or glenoid, neck are strongly debated in the relevant literature. Analysis of the respective studies, however, revealed a considerable confusion in terms of definition, terminology and diagnosis. In addition, there are few studies, primarily case reviews, dealing in detail with these fractures. The aim of this article is to present detailed information about fractures of the scapular neck, based on the analysis of our own experience and of the published literature. MATERIAL AND METHODS: Our group of 17 fractures of the scapular neck comprised 14 men and three women, with a mean age of 38 years (range, 24-55). The authors diagnosed four fractures of the anatomical neck, nine fractures of the surgical neck and five trans-spinous fractures of the neck. Of these 17 scapular neck fractures, six fractures were treated non-operatively, and 11 fractures were operated on via the posterior Judet approach. The mean follow-up was 4.9 years (range, 1-11). RESULTS: Fractures in all six non-operatively treated patients healed without complications in the anatomical position and with full function of the shoulder. In 11 operatively treated patients, all fractures of the scapula and clavicle healed within three months. In nine cases the function of the shoulder was subjectively and objectively assessed as normal, and in the remaining two cases as fair. CONCLUSION: The term "scapular, or glenoid, neck" covers three different types of fractures, i.e., fracture of the anatomical neck, fracture of the surgical neck and trans-spinous neck fracture. Fractures of the surgical neck are divided into stable, fractures with rotational instability and fully unstable fractures, depending on the integrity of the coracocacromial and coracoclavicular ligaments. Accurate diagnosis of fractures of the scapular neck requires 3D CT reconstructions. Undisplaced or minimally displaced fractures may be treated non-operatively, markedly displaced fractures constitute an indication for osteosynthesis via the Judet approach.
- MeSH
- dospělí MeSH
- fraktury kostí * klasifikace diagnóza chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lopatka anatomie a histologie diagnostické zobrazování zranění MeSH
- mladý dospělý MeSH
- rentgendiagnostika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The authors operated on 22 patients with scapular body fractures, with a mean age of 35 years. The minimal follow-up was 12 months. All patients were treated from the Judet posterior approach. The study included 14 cases of an isolated body fracture, three of scapular body fracture combined with fracture of the scapular neck and five of glenoid fossa fracture. In all 14 cases where a 3D computed tomography (CT) reconstruction was performed prior to operation, intraoperative findings corresponded to this reconstruction. In eight cases without preoperative 3D CT reconstruction, the correct type of fracture was identified in only two cases. We also identified three basic types of fractures of the lateral border of the scapula. The anatomical relationship between the glenoid fossa and scapular body, congruency and stability of the shoulder joint was achieved in all cases. The average constant score was 94.
- MeSH
- dospělí MeSH
- fraktury kostí diagnostické zobrazování chirurgie MeSH
- interní fixátory MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lopatka diagnostické zobrazování zranění chirurgie MeSH
- mladý dospělý MeSH
- počítačová rentgenová tomografie MeSH
- pooperační komplikace MeSH
- poranění ramene MeSH
- ramenní kloub patofyziologie chirurgie MeSH
- rozsah kloubních pohybů MeSH
- úrazy a nehody MeSH
- vnitřní fixace fraktury metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH