Inferior glenoid fossa fractures: patho-anatomy and results of operative treatment.

INTRODUCTION: A typical feature of inferior glenoid fractures is a distal fragment separated from the glenoid fossa. In most cases, the inferior glenoid fractures are associated with a fracture of the scapular body. However, there are no detailed studies of inferior glenoid fractures, and only brief mentions can be found in the literature in this respect.

MATERIAL AND METHODS: The basic group comprised 42 patients, with the mean age of 48 years, who sustained 42 fractures of the inferior glenoid. In this group, the scapular fracture anatomy was evaluated, based on 3D CT reconstructions. A total of 29 patients operated on were followed up for 12 to 128 months after injury (average, 52 months), three patients were lost to follow up. The results of the operative treatment, including complications, were assessed radiologically and functionally.

RESULTS: Fracture anatomy was described from various aspects, i.e., the size of the articular surface carried by the separated glenoid fragment, the existence of multiple articular fragments, the size of the separated glenoid fragment and the extent of injury to the scapular body. All 29 operatively treated fractures radiologically healed within three months. Full and pain-free range of motion was restored in 18 patients; in eight patients it was limited by 20 degrees and in three patients by more than 40 degrees. The mean Constant score was 82.

CONCLUSION: Fractures of the inferior glenoid fossa requires CT examination, including 3D CT reconstruction with subtraction of the surrounding bones. Displaced fractures are indicated for operative treatment.