抄録
The Ideberg type1 fracture is the most common glenoid fracture, and reports of arthroscopic reduction and internal fixations have been increased. On the other hand, types2 ∼ 5 are rare fracture types. We reported a case of Ideberg type4 fracture treated by arthroscopic reduction and internal fixation.
A 20-year-old man had injured his right pneumothorax, right 1st and 2nd rib fractures, fracture of the right distal clavicle and fracture of right scapula with the glenoid in a traffic accident. After the pneumothorax had improved, surgery was performed. Distal clavicle was fixed by tension band wiring first. Coracoid process was exposed with deltopectral approach and we reduced the articular surface under arthroscopy by grasping the coracoid process, and fixed with cannulated screw. ROM exercise started 3 weeks after surgery. The repair of articular surface was observed in the eight months postoperative CT and 2nd look surgery. Active flexion was 150 degrees, external rotation was 50 degrees and internal rotation was Th10 at 9 months after the operation.
The glenoid fractures were very rare fractures and only a few of them require surgery. Although posterior approach is recommended for the Ideberg type4 fracture, it is necessary to cut the deltoid muscle to approach the glenoid cavity. To the contrary, our method was less invasive because of no invasion to the deltoid muscle.
Arthroscopic reduction and internal fixation for the Ideberg type4 fracture was better not only to preserve the deltoid muscle, but also to achieve a better clinical result.
