Fixation of Glenoid Fractures

Assiut University

Status: Unknown

Conditions: Glenoid; Fracture

Treatments: Procedure: Internal Fixation of Glenoid Fractures

Study type: Observational

Funder types: Other

Identifiers

NCT04070859

Glenoid Fractures Fixation

Details and patient eligibility

About

Scapula fractures are uncommon but make up 3-5% of all shoulder girdle injuries. Moreover, intraarticular glenoid fossa fractures represent only 1% of scapula fractures.

They are frequently found with concomitant injuries to chest, head, brachial plexus and humerus.

The glenoid is an oval shaped portion on the lateral border of the scapula that articulates with the circular rounded end of the humeral head.

Superiorly the glenoid is part of the superior shoulder suspensory complex (SSSC) consisting of superior glenoid, coracoid process, coracoclavicular ligaments, distal end of the clavicle, acromioclavicular joint, coracoacromial ligament and acromial process.

Subsequently, stability of the shoulder is a complex mechanism in which muscles, ligamentous and capsular restraints, the labrum and joint vacuum, each play a role depending on position and activity.

The history of patients with glenoid fractures will mostly consist of either shoulder dislocation or direct trauma to the humeral head. The affected arm is "pseudo-paralysed" and supported in adduction and internal rotation.

Because of a thick layer of soft tissue, only mild swelling and ecchymosis may be seen .

For the diagnosis of scapular injuries X-rays are routinely taken , MSCT scanning , MRI & Nerve conduction velocity may be done.

Main parameters defining operative treatment are instability, the articular surface fragment size and the degree of displacement. However, concomitant injuries (e.g. thorax, head, extremity fractures, plexus lesion), age, occupation, level of activity and dominance, play a key role in management.

Enrollment: 30 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 1-Fracture Pattern:

  1. All partial & complete articular Glenoid Fractures: with Non congruent articular surface; >20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.
  2. All Extra articular Glenoid fractures: with >20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.
  3. All Extra articular Glenoid fractures e >20° difference In GPA compared to The GPA of the normal side.
  4. Fractures e an intra-articular gap or step-off of 4 to 10 mm or more.
  5. If glenohumeral instability is present after dislocation. 2-Age: skeletally mature patients (>18-60y)

Exclusion criteria

• 1- Fractures e an intra-articular gap or step-off < 4 mm. 2- Timing of surgery not more than 2 weeks from the initial trauma 3- Polytraumatized patients e ISS>14. 4- Associated Neurovascular Injury. 5- Open Fractures. 6- Associated comorbidities e.g. (Uncontrolled DM, Renal impairment).