Glenoid fractures: which ones can be fixed through the scope?

Abstract

Fractures of the glenoid encompass a wide range of morphologies from glenoid rim fractures after a shoulder dislocation to multi-fragmentary glenoid fossa fractures after high energy trauma. An equally wide range of treatment strategies have been described. A relatively new surgical option is arthroscopic repair of glenoid fractures, first described by Cameron in 1998. Over the past 20 years, an explosion of all-arthroscopic and arthroscopic-assisted fixation techniques have been described for many different fracture types. Currently, most anterior and posterior glenoid rim fractures can be fixed arthroscopically with good outcomes and a low complication rate based on available evidence. Some fractures of the glenoid fossa may also be amenable to arthroscopic fixation, particularly fractures with a superior fragment or transverse fracture pattern allowing for safe percutaneous screw placement. While the scope of arthroscopic glenoid fracture fixation continues to expand, all surgeons treating these injuries must be comfortable with open techniques and not sacrifice quality of reduction for a minimally invasive approach.