Aktuelle Konzepte bei der Versorgung von Glenoidfrakturen

Glenoid fractures require a precise treatment strategy to ensure glenohumeral joint stability and restore shoulder function; however, the treatment is still controversially discussed and depends on a range of factors including glenohumeral stability, joint alignment, the extent of articular involvement, the number of fragments as well as patient-specific functional demands. Solitary glenoid fractures can be treated conservatively with good results if the shoulder is clinically stable and joint alignment is confirmed radiologically. In cases of glenohumeral instability, decentralization of the humeral head, multiple fragment fractures or concomitant injuries, surgical treatment is recommended especially in young and active patients. A variety of fixation techniques are available for surgical glenoid reconstruction; however, the current literature is increasingly moving away from the use of metal screws. The arthroscopic approach is preferred to avoid access morbidity as well insufficiency of the subscapularis muscle and is associated with lower complication rates. Long-term evaluations of recurrence and arthrosis rates remain to be seen following conservative as well as surgical treatment of glenoid fractures.