Glenoid fracture morphology predicts associated trauma and patient-reported outcome measures (PROMs); A multicenter...

Although glenoid fractures are relatively uncommon, they may be associated with severe concomitant injuries, including thoracic, vertebral, and neurovascular trauma. Large-scale studies evaluating the relationship between fracture morphology, associated injuries, and functional outcomes remain limited. The purpose of this multicenter study was to classify glenoid fractures according to the Ideberg Classification system, identify associated injuries, and investigate their relationship with functional outcomes.

In this retrospective multicenter cohort study, 242 patients diagnosed with glenoid fractures across five trauma centers were evaluated. Glenoid fractures were classified according to the Ideberg and AO/OTA systems by five independent observers. For statistical analyses, the Ideberg classification was grouped into three categories (Type I, Type II-III, and Type IV-V). Data on associated injuries (including extremity, thoracic, abdominal, craniospinal, and neurovascular injuries) were obtained from hospital records. Functional outcomes were assessed using the Constant-Murley (CM) and American Shoulder and Elbow Surgeons (ASES) scores.

The mean age of the cohort was 51.5 ± 18.1 years, and 66.9% of the patients were male. Ideberg Type I fractures were the most frequent (59%), whereas Type V fractures were the least common (8%). Glenohumeral dislocation was the most common associated pathology, observed in 70.2% of patients, particularly in Type I fractures (88%; p < 0.001). In contrast, thoracic injuries (31.4%), vertebral fractures (8.3%), and brachial plexus injuries (2.5%) were significantly more frequent in Type IV-V fractures (all p < 0.001). At a mean follow-up of 21.9 ± 13.0 months, the mean ASES score was 88.5 ± 10.1 and the mean CM score was 90.0 ± 10.5. Both functional scores decreased significantly with increasing Ideberg fracture severity from Type I to Type V (p < 0.001).

Fracture morphology in glenoid fractures has a substantial impact on both the severity of associated injuries and functional outcomes. While Type I fractures are commonly associated with glenohumeral dislocation, Type IV-V fractures reflect higher-energy trauma and are frequently accompanied by thoracic, vertebral, and neurovascular injuries, resulting in poorer functional outcomes. Therefore, a systematic trauma assessment should be performed in patients with glenoid fractures, and fracture morphology should be considered a key parameter in treatment planning.