Glenoid & Scapula Fractures

Glenoid Fractures


Indications for Surgery



- > 5mm step

- > 1/4 glenoid rim and displaced


Ideberg Classification Intra Articular Fracture


Type I


Fractures of the Glenoid rim

I A anterior 

I B posterior


Differentiate from small bony Bankart

- ORIF if > 1/4th or > 10 mm displaced (Neer)


Case 1


Glenoid Rim Fracture 1Glenoid Rim Fracture 2Glenoid Rim Fracture 2Glenoid Rim ORIF


Case 2


Glenoid FractureGlenoid Fracture CTGlenoid Fracture CT 2Glenoid ORIF


Case 3


Scapular fracture intraarticular glenoid axialScapula ORIF APScapula ORIF Lateral


Case 4


Glenoid Frac APGlenoid Frac AxialGlenoid Fracture CT


Type II


Transverse fracture through glenoid fossa

- inferior triangular fragment 

- exits lateral border scapula


Glenoid FractureGlenoid ORIF


Scapula Fracture XrayScapula Fracture Intra articular CT SagittalScapula Fracture Intra articular Glenoid Coronal CT


Glenoid Fracture 1Glenoid Fracture 2Glenoid Fracture 3


Type III


Oblique fracture through the glenoid    

- exiting through superior border of the scapula

- associated with AC fracture or ACJ dislocation

- includes the Coracoid


Type IV


Similar to II, larger superior fragment

- horizontal

- exiting thru the medial border of the blade


Glenoid FractureGlenoid Fracture 2Glenoid Fracture 3


Glenoid ORIFGlenoid ORIF 2Glenoid ORIF 3


Type V



- Va =IV+II




Type VI


Extensive comminution


Glenoid Malunion


Case 1

- untreated glenoid rim fracture

- patient with chronic instability

- treated with glenoid osteotomy


Glenoid Fracture Malunion CTGlenoid Osteotomy APGlenoid Osteotomy Lateral


Scapular Fractures


A.  Body


Often don't need ORIF
- well splinted by fascia / haematoma

- can treat non operatively


Scapula Body FractureScapular Body Fracture CT


Scapular Blade Fracture CTScapular Blade Fracture CT 2


Indications for surgery

- > 45 degrees of angulation of body


Scapular Body > 45 degrees


B.  Neck


Indications for surgery

- > 450 angulation

- > 10 mm displaced (i.e. medial displacement


Case 1

- > 1 cm medial displacement

- ORIF via posterior / modified Judet approach


Scapula Neck FractureGlenoid Neck Fracture


Scapula ORIFScapula ORIF 3


Case 2


Glenoid DisplacementGlenoid Displacement CT


Glenoid ORIF 1Glenoid ORIF 2


C.  Spine


Scapula Blade Fracture CTScapula Spine Fracture



D.  Acromion


Spine scapula fracture


E.  Coracoid


Coracoid Fracture 1Coracoid Fracture 2


Coracoid Fracture CT 1Coracoid Fracture CT 2Coracoid Fracture CT 3Coracoid Fracture CT 4


Combined Glenoid and Scapula Fractures


Case 1

- displaced glenoid fracture and neck fracture

- ORIF both through posterior / Judet approach


Glenoid Scapular FractureComplex Scapular Fracture CT 1Complex Scapular Fracture CT2Complex Scapular ORIF