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

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 double-cortical 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.