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Scientific Articles   |    
Surgical and Functional Outcomes After Operative Management of Complex and Displaced Intra-Articular Glenoid Fractures
Jack Anavian, MD1; Erich M. Gauger, MD2; Lisa K. Schroder, BS, MBA2; Coen A. Wijdicks, MSc3; Peter A. Cole, MD2
1 Department of Orthopaedics, Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903
2 Department 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
3 Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO 81657
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  • Disclosure statement for author(s): PDF

Investigation performed at the Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Minnesota, Regions Hospital, Saint Paul, Minnesota



Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Apr 04;94(7):645-653. doi: 10.2106/JBJS.J.00896
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Abstract

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.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    Vijay Kumar Badhwar MBBS, MC (Orthopaedic Surgery)
    Posted on April 07, 2012
    No comparison was made between surgical and conservative treatment
    Dr Badhwar Nursing Home, Delhi, India

    In this article no comparison was made between surgical and conservative treatment of stable displaced glenoid fractures with a gap more than 4mm. In most displaced glenoid fractures with a stable shoulder joint there are good functional results.

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