Arthroscopic Transosseous Suture Button Fixation Technique for Treatment of Large Anterior Glenoid Fracture

Abstract

To date, several open and arthroscopic surgical procedures are available for the treatment of anterior glenoid fractures after anterior shoulder dislocation. Open approaches require extensive soft-tissue dissection and are associated with poorer outcomes. Arthroscopic screw fixation techniques are technically challenging and related to complications as well, for example, risk of brachial plexus injury or hardware impingement. Alternative arthroscopic fixation techniques use suture anchors placed along the fracture rim with sutures passed around the fragment. However, these techniques require an intact capsulolabral complex and cannot be used effectively for large fracture fragments. This article describes a safe interfragmentary, transosseous, all-arthroscopic procedure using a doubleecortical button fixation technique. This method can be used to achieve anatomic reduction and stable fixation of intermediate to large anterior glenoid fractures while minimizing the difficulties associated with previously described arthroscopic or open approaches.

Arthroscopic treatment of a multifragmentary glenoid fracture

“…Originally, the glenoid guide was designed for implantation of a button-suture construct, but allowed for safe placement of the posterior screw in the present case [4]. Also, the posterior bullets aided in fracture reduction.…”

“…Traditionally, these procedures have been performed using extensive arthrotomy, which is associated with higher risks for intraoperative and postoperative complications [2]. Thus, several arthroscopic techniques have been developed to address two-part fractures (anterior rim, posterior rim, or transverse; [3,4]). However, these techniques remain technically challenging, even more so in cases of multifragmentary glenoid fractures, i.e., more than two articular fragments.…”

“…Fig. 1a) applying modifications of recently described arthroscopic techniques for two-part glenoid fractures [3,4].…”

Chondral Damage After Arthroscopic Repair Techniques for Acute Bony Bankart Lesions: A Biomechanical Study

“…Two other suture anchors are then placed superior and inferior to the primary anchor to capture the labrum and capsule. Wafaisade et al 48 described a similar technique using a transosseous suture button. By utilizing transosseous suture passage, these repair techniques avoid significant intra-articular suture placement.…”

Arthroscopic Reduction and Stable Fixation of an Anterior Glenoid Fracture With 4 Buttons

“…Arthroscopic fixation of large anterior glenoid fractures (Ideberg type 1) 16 using interfragmentary compression systems, originally designed for treating shoulder instability with bone deficit to add and fix bone grafts, has already been described by several authors. [17][18][19][20][21]…”