Anterioinferior glenoid fracture

Fracture type
Operative indications
Operative indications
Approach
Arthroscopic reduction
Arthroscopic reduction
Arthroscopic reduction
Arthroscopic reduction

 Fx. type of Glenoid (by Ideberg) 

Op.  indication of  Type II-VI  Fx.

step off  > 5mm


severe separation of articular surface


inferior fragment displacement with  head subluxation



Op. indications for glenoid Type I


Anterior rim Fx. (Type I a) 

1/4 articular involvement 

    & 10mm anterior displacment  

Anterior axillary approach 

Deltopectoral approach


Posterior rim Fx. (Type I b)

1/3 articular involvement

Limited Posterior axillary approach 


Consider arthroscopic approach

Approach – Anterior, deltopectorial

Position :Beach chair position


Indications

1. Anterioinferior glenoid fracture 

2. Transverse glenoid fracture 

3. Combined coracoid fracture


Structure in risk 

- Cephalic vein

- Musculocutaneous nerve 

- Axillary nerve

- Posterior humeral circumflex artery

Arthroscopic Reduction for Glenoid Fracture

Sitting position using beach chair

Total shoulder arthroplasty 

back up plan. 


Headless cannulated screw fixation


Suture Anchor fixation


Endobutton fixation



Arthroscopic Reduction for Glenoid Fracture

Headless cannulated screw fixation

cannulated screwdriver was too short to traverse the length of the arthroscopic cannula




Arthroscopic Reduction for Glenoid Fracture

Endobutton fixation





Arthroscopic Reduction for Glenoid Fracture

Suture Anchor fixation







3-4 suture anchors on the edge of the healthy glenoid

Augment suturing of the bony fragment itself

labrum fixation adjacent to the fragment, both inferior and superior


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