Executive Editor: Joseph Schatzker

Authors: Jonas Andermahr, Michael McKee, Diane Nam

Scapula Glenoid fossa, extraarticular, simple

back to skeleton

Glossary

General considerations

These fractures do not require surgery unless significantly displaced. The degree of displacement is judged by measuring the angle between the plane of the glenoid and the lateral scapular border. If the angle of displacement is greater than 20° than the normal anatomical angle, then surgery is indicated. If the displacement is left untreated, significant loss of shoulder motion will ensue.

Nonoperative treatment
Main indication Skill Equipment
<20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle. Basic surgical experience, no specialized skills Basic equipment only


Supporting indications

  • Risk of surgery outweigh benefits

Advantages

  • No operative risks
  • No anaesthetic risk

Disadvantages

  • Delay in regaining full range of motion.
  • Increased risk of stiff shoulder

Contraindications

  • Neurovascular lesions
  • Associated fracture of humeral head which will be treated operatively
ORIF - Plate fixation
Main indication Skill Equipment
>20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle. Highly experienced and skilled surgeon Simple surgical and imaging resources


Supporting indications

  • Need for more stability and/or earlier mobilization

Advantages

  • Reduced risk of displacement
  • Earlier mobilization possible

Disadvantages

  • Possible need for hardware removal
  • Risk of nerve injury to the axillary and suprascapular nerve.

Contraindications

  • Patient unfit for surgery
  • Severe osteoarthritis
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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