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Surgical and Functional Outcomes After Operative Management of Complex and Displaced Intra-Articular Glenoid Fractures

Anavian, Jack MD; Gauger, Erich M. MD; Schroder, Lisa K. BS, MBA; Wijdicks, Coen A. MSc; Cole, Peter A. MD

Journal of Bone & Joint Surgery - American Volume: 4 April 2012 - Volume 94 - Issue 7 - p 645–653
doi: 10.2106/JBJS.J.00896
Scientific Articles
Supplementary Content

Background: Operative treatment is indicated for displaced fractures of the glenoid fossa. However, little is known regarding functional outcomes in these patients. This study assesses surgical and functional results after treatment of displaced, high-energy, complex, intra-articular glenoid fractures.

Methods: Thirty-three patients with displaced intra-articular fractures of the glenoid were treated surgically between 2002 and 2009. The indications for operative treatment included articular fracture gap or step-off of ≥4 mm. Twenty-five patients also had extra-articular scapular involvement. A posterior approach was utilized in twenty-one patients, an anterior approach in seven, and a combined approach in five. Functional outcomes, including Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-36 (SF-36) scores, shoulder motion and strength, and return to work and/or activities, were obtained for thirty patients (91%).

Results: At a mean follow-up of twenty-seven months (range, twelve to seventy-three months), all patients had radiographic union of the fracture. The mean DASH score was 10.8 (range, 0 to 42). All mean SF-36 subscores were comparable with those of the normal population. Twenty-six patients (87%) were pain-free at the time of follow-up, and four had mild pain with prolonged activity. Twenty-seven (90%) of thirty patients returned to their preinjury level of work and/or activities.

Conclusions: Our data suggest that surgical treatment for complex, displaced intra-articular glenoid fractures with or without involvement of the scapular neck and body can be associated with good functional outcomes and a low complication rate.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopaedics, Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903

2Department of Orthopaedic Surgery, University of Minnesota, Regions Hospital, 640 Jackson Street, St. Paul, MN 55101. E-mail address for P.A. Cole: Peter.A.Cole@HealthPartners.com

3Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO 81657

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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