肩甲骨関節窩骨折に対して関節鏡を併用して内固定を行った 2 症例

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We experienced two cases of the glenoid fracture treated by the internal fixation with the arthroscopic assistance.The first case was a 27-year-old man. He fell 3 meters to the ground and suffered Type 3 glenoid fracture in Ideberg classification. The operation was performed in a lateral position. We inserted two K-wires into the coracoid process, and reduced an angular deformity of the glenoid surface using the joy-stick technique. Then, a cannulated screw was inserted from the coracoid process to the glenoid. The reduction and fixation were assessed with arthroscope, and they were acceptable. The clinical result was satisfactory (98 points in JOA score).The second case was a 21-year-old man. He fell 2 meters to the ground and suffered the glenoid fracture combined Type 2 and 3. The glenoid was broken into two fragments, and they showed an angular deformity about 80 degrees. The operation was performed in a beach-chair position, using posterior elevation position subdeltoid approach (Brodsky approach) with the arthroscopic assistance. We could minimize the detatchment of deltoid muscle by elevating the upper extremity and could perform the internal fixation less invasively, using the arthroscope, without cutting the joint capsule. The clinical result was also satisfactory (96 points in JOA).For a transverse fracture of the glenoid, the joy stick technique was useful for the superior fragment. Brodsky approach was also useful to reduce and fix the inferior fragment. Furthermore, the arthroscopic assistance was very valuable to evaluate the reduction of the joint surface, and the handling of the image intensifier was very important.

肩甲骨関節窩骨折に対して関節鏡を併用して内固定を行った 2 症例

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