Fragment-specific management for scapular glenoid fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Skeletal Anatomy

Background:

• Scapular glenoid fractures are rare, comprising ~0.1% of all fractures.
• Their diverse morphology and complex anatomy present surgical challenges.
• Optimal surgical approach selection is critical for favorable outcomes.

Purpose of the Study:

• Evaluate the efficacy of a "fragment-specific management" strategy for scapular glenoid fractures.
• Correlate surgical approach selection with fragment location and morphology.
• Assess radiological and functional outcomes of this management strategy.

Main Methods:

• Retrospective analysis of 15 patients with scapular glenoid fractures (2013-2024).
• Surgical indication: articular step-off/gap ≥ 4 mm on 3D-CT.
• Surgical approaches (deltopectoral, Brodsky, superior, Judet) selected based on fragment characteristics.
• Evaluated radiological outcomes, complications, and functional shoulder metrics (ROM, NRS pain).

Main Results:

• Mean patient age 52.2 years; 12 males, 3 females.
• Ideberg classification distribution: 6 Type I, 2 Type II, 3 Type III, 2 Type IV, 2 Type V.
• Mean preoperative step-off/gap (5.2 mm / 8.5 mm) improved to 0.1 mm / 0.6 mm postoperatively.
• No infections or nonunions; mean shoulder ROM: flexion 144°, abduction 147°, external rotation 46°.
• Mean NRS pain score was 0.8; all cases achieved bone union and satisfactory function.

Conclusions:

• Fragment-specific management provides excellent reduction and stable fixation for scapular glenoid fractures.
• This approach leads to favorable functional outcomes with no major complications.
• Fragment-specific management is a safe and effective treatment strategy for these complex fractures.