Clinical trial NCT04070859: Fixation of Glenoid Fractures
Official title: Evaluation of Internal Fixation Of Glenoid Fractures
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Glenoid; Fracture
Keywords: internal fixation
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2019-08-28
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: ALl Healthy Young Adults e out comorbidities ( DM, uncontrolled HTN,...etc)

Brief summary: 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.


Eligibility criteria: Inclusion Criteria:

* 1-Fracture Pattern:

  1. 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.
  2. All Extra articular Glenoid fractures: with \>20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.
  3. All Extra articular Glenoid fractures e \>20° difference In GPA compared to The GPA of the normal side.
  4. Fractures e an intra-articular gap or step-off of 4 to 10 mm or more.
  5. 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).

Primary outcomes:
measure: Evaluate the role of internal fixation of glenoid fracture in healthy adults by ASES score
timeFrame: Baseline
Secondary outcomes:
measure: Asses Fracture Union, Range of Motion Asses functional outcome by DASH score Asses Fracture Union, Range of Motion Asses functional outcome by DASH score
timeFrame: Baseline
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: ‪Diaa Mohammad‬
Study officials:
affiliation: Assiut University
name: Ali Mohamadean
role: STUDY_DIRECTOR
affiliation: Assiut University
name: Galal El-Din Zaki
role: STUDY_CHAIR
affiliation: Assiut University
name: Mahmoud Badran
role: STUDY_DIRECTOR
affiliation: Assiut University
name: Diaa El-Din Mohamed
role: PRINCIPAL_INVESTIGATOR
References:
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