Glenoid fractures: a review of pathology, classification, treatment and results

Glenoid fractures are rare, and relatively little is known about their mechanism, fracture pattern and optimal treatment strategies. The avulsions and rim fractures are strongly associated with anterior shoulder dislocations. Fossa fractures are mostly seen in high energy trauma patients as direct impact of the humeral head against the glenoid fossa. CT-scanning can be very useful in diagnosing the extend of injury and relation of humeral head with the main fragment of the glenoid. Fracture classification systems, have been designed mainly based on trauma mechanism, location and severity of fracture pattern. Treatment depends on instability, the degree of displacement and the articular surface fragment size, but is conservative in most cases. Due to the increase of arthroscopic fixation possibilities, operative treatment may increase. In this review, we have tried to summarize the available evidence into a treatment algorithm for different types of glenoid fractures. With regard to best functional outcome, an anatomical and concentric joint restoration should be the goal of treatment. Outcome is generally good in conservative and operative treatment, but exact data is difficult to appreciate, due to heterogeneity and comorbidities in different studies.