Fixation of Glenoid Fractures

Study Overview
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Brief Summary
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Scapula fractures are uncommon but make up 3-5% of all shoulder girdle injuries. Moreover, intraarticular glenoid fossa fractures represent only 1% of scapula fractures. They are frequently found with concomitant injuries to chest, head, brachial plexus and humerus. The glenoid is an oval shaped portion on the lateral border of the scapula that articulates with the circular rounded end of the humeral head. Superiorly the glenoid is part of the superior shoulder suspensory complex (SSSC) consisting of superior glenoid, coracoid process, coracoclavicular ligaments, distal end of the clavicle, acromioclavicular joint, coracoacromial ligament and acromial process. Subsequently, stability of the shoulder is a complex mechanism in which muscles, ligamentous and capsular restraints, the labrum and joint vacuum, each play a role depending on position and activity. The history of patients with glenoid fractures will mostly consist of either shoulder dislocation or direct trauma to the humeral head. The affected arm is pseudo-paralysed and supported in adduction and internal rotation. Because of a thick layer of soft tissue, only mild swelling and ecchymosis may be seen . For the diagnosis of scapular injuries X-rays are routinely taken , MSCT scanning , MRI & Nerve conduction velocity may be done. Main parameters defining operative treatment are instability, the articular surface fragment size and the degree of displacement. However, concomitant injuries (e.g. thorax, head, extremity fractures, plexus lesion), age, occupation, level of activity and dominance, play a key role in management.

Official Title
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Evaluation of Internal Fixation Of Glenoid Fractures

Conditions
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Glenoid; Fracture

Intervention / Treatment
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* Procedure: Internal Fixation of Glenoid Fractures


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1-Fracture Pattern: All partial & complete articular Glenoid Fractures: with Non congruent articular surface; >20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle. All Extra articular Glenoid fractures: with >20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle. All Extra articular Glenoid fractures e >20° difference In GPA compared to The GPA of the normal side. Fractures e an intra-articular gap or step-off of 4 to 10 mm or more. If glenohumeral instability is present after dislocation. 2-Age: skeletally mature patients (>18-60y) Exclusion Criteria: 1- Fractures e an intra-articular gap or step-off < 4 mm. 2- Timing of surgery not more than 2 weeks from the initial trauma 3- Polytraumatized patients e ISS>14. 4- Associated Neurovascular Injury. 5- Open Fractures. 6- Associated comorbidities e.g. (Uncontrolled DM, Renal impairment).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Internal Fixation of Glenoid Fractures|Internal Fixation via (Paltes & Screws, Tension bands. etc)|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluate the role of internal fixation of glenoid fracture in healthy adults by ASES score | regarding functional outcome at 6 months and 1 year. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Asses Fracture Union, Range of Motion Asses functional outcome by DASH score Asses Fracture Union, Range of Motion Asses functional outcome by DASH score | regarding functional outcome at 6 months and 1 year. | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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internal fixation