Glenoid Fractures
Indications for Surgery
ORIF
- > 5mm step
- > 1/4 glenoid rim and displaced
Ideberg Classification Intra Articular Fracture
Type I
Fractures of the Glenoid rim
I A anterior
I B posterior
Differentiate from small bony Bankart
- ORIF if > 1/4th or > 10 mm displaced (Neer)
Case 1
Case 2
Case 3
Case 4
Type II
Transverse fracture through glenoid fossa
- inferior triangular fragment
- exits lateral border scapula
Type III
Oblique fracture through the glenoid
- exiting through superior border of the scapula
- associated with AC fracture or ACJ dislocation
- includes the Coracoid
Type IV
Similar to II, larger superior fragment
- horizontal
- exiting thru the medial border of the blade
Type V
Combination
- Va =IV+II
- Vb=IV+III
- Vc=IV+III+II
Type VI
Extensive comminution
Glenoid Malunion
Case 1
- untreated glenoid rim fracture
- patient with chronic instability
- treated with glenoid osteotomy
Scapular Fractures
A. Body
Often don't need ORIF
- well splinted by fascia / haematoma
- can treat non operatively
Indications for surgery
- > 45 degrees of angulation of body
B. Neck
Indications for surgery
- > 450 angulation
- > 10 mm displaced (i.e. medial displacement
Case 1
- > 1 cm medial displacement
- ORIF via posterior / modified Judet approach
Case 2
C. Spine
D. Acromion
E. Coracoid
Combined Glenoid and Scapula Fractures
Case 1
- displaced glenoid fracture and neck fracture
- ORIF both through posterior / Judet approach