A glenoid fracture is a fracture of the shoulder socket. It often leads to instability of the shoulder joint. However, glenoid fractures can be treated well with the help of modern trauma surgery procedures. Here you will find further information and selected glenoid fracture specialists and centers.
The shoulder blade carries the shoulder socket on its side, which is shaped like a small soup plate. The ball of the humeral head fits exactly into the curve of this "plate". The glenoid cavity and the humeral head together form the main part of the shoulder joint.
Anatomy of the shoulder with humeral head and glenoid © bilderzwerg | AdobeStock
Glenoid fractures can be divided into two main areas.
There are the smaller marginal fractures, usually located only on the anterior edge, which occur in the context of dislocated shoulders, such as
These fractures of the shoulder socket are also known as Bankart fractures. They are usually caused by an accident mechanism in which the impact energy is relatively low (low-energy mechanism). For example, the shoulder socket can partially break off in a simple fall due to the dislocation mechanism.
Glenoid fractures that affect the entire shoulder socket are referred to as a high-energy mechanism due to the high forces required. Traffic accidents are often the cause of such glenoid fractures.
All glenoid fractures are relatively painful.
The smaller Bankart fractures may appear small in size, but they have a major functional impact.
The glenoid cavity is much smaller than the corresponding humeral head. A large part of the joint stability is therefore provided by the surrounding soft tissue, which is attached to the edge of the glenoid cavity. If this rim is broken off, the soft tissue complex cannot maintain its stabilizing function either. As a result, the shoulder joint as a whole often becomes unstable.
This means that the joint often dislocates and those affected have an unpleasant feeling of instability. There is a feeling that you cannot rely on the shoulder joint.
This often leads to avoidance of extensive movements and a significant reduction in the range of motion. The complex comminuted fractures are also so painful that the affected patients usually keep the shoulder joint completely immobilized in a resting position.
A fracture of the glenoid cavity is diagnosed using X-rays. Computed tomography (CT) or magnetic resonance imaging (MRI) can also be used for more complex fractures.
The common problem of all glenoid fractures is their direct impact on the stability of the shoulder joint.
Young, athletically active patients usually have high demands on the mobility of their shoulder. For this reason, almost all glenoid fractures require surgical treatment.
The aim of any surgical treatment is to return the displaced pieces of bone to their original position. They must be fixed there until they have grown back into place. For fixation , the trauma surgeon often uses
The smaller marginal fractures or Bankart fractures can often be treated using arthroscopic shoulder surgery. Shoulder arthroscopy is a minimally invasive procedure in which the surgeon makes very small incisions in the skin.
A thin tube is inserted into the joint through a small incision. At the tip of the tube is a camera lens. The surgeon sees the image from the camera magnified several times on a monitor. Tiny instruments can also be brought to the surgical site through very small incisions.
With arthroscopy, it is possible to return the displaced bone to its original position and fix it there.
In the case of more complex fractures of the shoulder socket, a large open operation with screws and plates may be necessary.
Illustration of a shoulder arthroscopy using the example of bursitis © bilderzwerg | AdobeStock
If the pieces of bone can be brought back into their original position and fixed there, the chances of healing are very good. In most cases, these glenoid fractures leave only a slight restriction of movement.
The more complex the accident and the greater the energy applied to the joint, the greater the damage to the cartilage and soft tissue. All of these joint fractures therefore carry a higher risk of osteoarthritis for patients.
Without surgery, the chances of recovery from glenoid fractures are very poor. Bankart fractures lead to an unstable shoulder that dislocates repeatedly. The more complex comminuted fractures heal in a malaligned position and thus usually lead to stiffening of the shoulder.
Injuries to the glenoid cavity have a direct impact on shoulder function and often lead to instability. Glenoid fractures can usually be easily repositioned using modern trauma surgery procedures. The fracture fragments can be fixed in such a way that the glenoid cavity heals largely in its original shape. The functional consequences are then minimal.
Unfortunately, complex glenoid fractures often lead to greater cartilage damage and therefore also to a higher risk of osteoarthritis.
Overall, a glenoid fracture is a complex injury with major potential consequences for the affected patient. Treatment should therefore be in the hands of experienced specialists.
Images: Radiological image material was kindly provided by Dr. Stefan Wirth.
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