Impact of Concomitant Thoracic Trauma on Functional Outcomes After Surgical Treatment of Glenoid Fractures

Background/Objectives: The minimally invasive posterior deltoid-sparing (MIPDS) approach has been described for glenoid fractures; however, its outcomes for Ideberg type Ib, II, III, IV, and V fractures and the influence of concomitant injuries on functional recovery remain poorly understood. This study aimed to report minimum 2-year functional outcomes of these fracture types treated with the MIPDS approach using mini-plates, and to investigate the effect of concomitant thoracic trauma on clinical outcomes. Methods: Thirty-one patients with operatively treated glenoid fossa fractures were stratified into three groups: isolated glenoid fracture, concomitant thoracic trauma, and concomitant ipsilateral upper extremity fracture. Functional outcomes were assessed using the Constant, UCLA, and DASH scores at a minimum follow-up of 2 years. Results: No postoperative infection or nonunion occurred. Mean union time was 9.4 ± 2.4 weeks. Patients with thoracic trauma demonstrated significantly worse functional outcomes across all three scores compared to both other groups: lower Constant scores (70.9 ± 7.5 vs. 85.5 ± 5.9 and 82.6 ± 11.7; p = 0.012 and p = 0.042), lower UCLA scores (24.6 ± 7.9 vs. 32.5 ± 3.0 and 31.1 ± 3.2; p = 0.010 and p = 0.012), and higher DASH scores (29.3 ± 14.2 vs. 7.9 ± 9.2 and 9.5 ± 9.9; p = 0.003 and p = 0.006). Multivariate linear regression confirmed thoracic trauma as an independent predictor of higher DASH scores (β = 12.75, 95% CI: 2.00-23.50, p = 0.031, R² = 0.344). Conclusions: The MIPDS approach provides safe and effective fixation for Ideberg type Ib, II, III, IV, and V glenoid fractures with satisfactory functional outcomes at minimum 2-year follow-up. Concomitant thoracic trauma is a significant negative predictor of functional recovery, and the possibility of inferior functional outcomes in this patient group should be considered.