Executive Editor: Joseph Schatzker

Authors: Jonas Andermahr, Michael McKee, Diane Nam

Scapula Glenoid fossa, partial articular, posterior simple

back to skeleton

Glossary

General considerations

Fractures of the articular rim render the joint unstable. This fracture is usually seen in patients with posterior shoulder dislocations and is therefore often associated with injuries of the posterior glenoid rim, the labrum, the dorsal capsula and the rotator cuff.

Nonoperative treatment
Main indication Skill Equipment
Low demand patients Basic surgical experience, no specialized skills Basic equipment only


Supporting indications

  • Additional osteoarthritis 
  • Full thickness rotator cuff tear

Advantages

  • No operative risks
  • No anaesthetic  risk

Disadvantages

  • Delay in regaining full range of motion
  • Increased risk of shoulder instability
  • Increased risk of stiff shoulder and arthrosis
ORIF - Lag screw fixation
Main indication Skill Equipment
Large enough fragments to accommodate ORIF - lag screw fixation. Some specialized surgical experience Simple surgical and imaging resources


Supporting indications

  • Need for more stability and/or earlier mobilization

Advantages

  • Reduced risk of displacement
  • Earlier mobilization possible
  • Additional shoulder injury can be addressed

Disadvantages

  • Possible need for hardware removal
  • Risk of nerve injury to the axillary and suprascapular nerve.
  • Risk of screw head interfering with the humeral head
  • Increased approach morbidity

Contraindications

  • Patient unfit for surgery
  • Severe osteoarthritis
MIO - Lag screw fixation
Main indication Skill Equipment
Large enough fragments to accommodate ORIF - lag screw fixation. Highly experienced and skilled surgeon Full specialized surgical and imaging resources


Supporting indications

  • Need for more stability and/or earlier mobilization

Advantages

  • Reduced risk of displacement
  • Earlier mobilization possible
  • Additional shoulder injury can be addressed
  • Less approach morbidity

Disadvantages

  • Possible need for hardware removal
  • Risk of screw head interfering with the humeral head

Contraindications

  • Patient unfit for surgery
  • Severe osteoarthritis
ORIF - Suture anchors
Main indication Skill Equipment
Fragments too small to accommodate ORIF - lag screw fixation. Highly experienced and skilled surgeon Full specialized surgical and imaging resources


Supporting indications

  • Need for more stability and/or earlier mobilization

Advantages

  • Reduced risk of displacement
  • Earlier mobilization possible
  • Additional shoulder injury can be addressed
  • Less approach morbidity

Disadvantages

  • Suture may cause foreign material granuloma

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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