Characteristics and Management of Ideberg Ⅰa Glenoid Fracture Combined with Rotator Cuff Injury

Pan Jianke; Li Feng; Luo Minghui; Yang Junzheng; Chen Haiyun; Zhao Jinlong; Yang Weiyi

Abstract：Objective To summarize the characteristics,diagnosis and treatment strategies of Ideberg type Ⅰ a fractures of the scapular pelvis combined with rotator cuff injuries.Methods A retrospective analysis was conducted on the data of 5 patients with scapular pelvis Ideberg type Ⅰ a fractures combined with rotator cuff injuries admitted to Guangdong Hospital of Traditional Chinese Medicine and Nanxiong Hospital of Traditional Chinese Medicine from January 2021 to April 2024.All patients were female,aged 60 to 86 years,with an average age of(71.40±9.02)years.All were fresh traumas.Four cases had dislocation of the shoulder joint at the time of injury.Three cases were simple Ideberg type Ⅰ a fractures of the scapular pelvis combined with rotator cuff injury.One case was combined with a proximal tibial fracture.One case was combined with an avulsion fracture of the greater tubercle of the humerus of the shoulder joint.Two cases of rotator cuff injury were initially missed at diagnosis.All were treated with arthroscopic exploration of the shoulder,reduction,and anchor fixation of glenoid fractures,and rotator cuff repair.Results The postoperative follow-up period ranged from 9 to 37 months,with an average of(19.60±9.62)months.No shoulder dislocation occurred during the follow-up period.After the operation,two cases had no pain in the shoulder joint,and the shoulder joint movement returned to normal.One case had no pain in the shoulder joint,and the movement of the shoulder joint was slightly limited,but it could meet the activity requirements of daily life.Two cases had occasional pain in the shoulder joint and mild limitation of shoulder joint movement,but could meet the activity requirements of daily life.Conclusion Ideberg type Ⅰ a fractures of the scapular pelvis combined with rotator cuff injuries are more common in the elderly.The accompanying rotator cuff injuries,nerve injuries,and osteoporosis may be overlooked.It is recommended that concurrent surgical treatment be carried out for combined rotator cuff fractures or greater tuberosity fractures of the humerus.The continuity between the lower part of the glenoid fracture and the labrum between the glenoid is conducive to the reduction and fixation of the fracture.When the reduction and fixation of the fracture are difficult,the double-row fixation technique or the Double pulley double-row anchor technique can be adopted.