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.
|<20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.|
- Risk of surgery outweigh benefits
- No operative risks
- No anaesthetic risk
- Delay in regaining full range of motion.
- Increased risk of stiff shoulder
- Neurovascular lesions
- Associated fracture of humeral head which will be treated operatively
|ORIF - Plate fixation|
|>20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.|
- Need for more stability and/or earlier mobilization
- Reduced risk of displacement
- Earlier mobilization possible
- Possible need for hardware removal
- Risk of nerve injury to the axillary and suprascapular nerve.
- Patient unfit for surgery
- Severe osteoarthritis
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|