Preoperative arthroscopic assessment of fractures about the shoulder

Soft tissue lesions in fractures about the shoulder are not completely defi ned by conventional imaging procedures. The purpose of the present study wa s to arthroscopically determine the soft-tissue pathology of the labrum, ca psuloligamentous, and rotator cuff structures associated with fractures of the proximal humerus and/or scapula and to correlate them to the fracture t ype. In a series of 80 fractures (52 proximal humeral fractures, 20 fractur e-dislocations, 8 glenoid or scapular fractures) arthroscopy was performed through a posterior approach under general anesthesia. Arthroscopy revealed significant numbers of labral, capsuloligamentous, and rotator cuff lesion s, as well as cartilage damage not identified by clinical examination or pr eoperative imaging. Fracture dislocations (Neer type VI) and more benign fr actures of the two-part variety an frequently associated with labral lesion s (in 56% and 31%, respectively). This data suggest that it is important no t to underestimate soft-tissue pathology in fractures that seem radiologica lly relatively harmless. Arthroscopic assessment in shoulder fractures is s hown to be a useful tool in completely understanding the extent of the inju ry.