PURPOSE: The aim of the article is to present the pathoanatomy and a new classification of glenoid fractures developed on the basis of analysis of 3D computed tomography (CT) examinations and intra-operative findings. MATERIALS AND METHODS: The study group comprised 90 patients (69 men and 21 women) who sustained glenoid fractures. Mean patient age was 47 years (17-92). In 77 nonpolytraumatised patients, anteroposterior (AP) radiographs of the affected shoulder girdle were taken, including Neer I and II views. All 90 patients underwent CT examination, combined in 73 of them with 3D CT reconstruction including subtraction of the humeral head, ribs and clavicle, from the anterior and posterolateral views. In total, 52 patients (58 %) were operated on and 38 42 %) were treated non-operatively. RESULTS: In total, five basic types of injuries to the glenoid were identified based on analysis of the separated portion of the glenoid fossa: including fractures of the superior glenoid (14 cases, 16 %), the anterior glenoid (23 cases, 23 %), the posterior rim of the glenoid (5 cases, 6 %), the inferior glenoid (38 cases, 42 %) and the entire glenoid (10 cases, 11 %). CONCLUSION: The proposed classification of glenoid fractures defines five basic types of fractures verified by 3D CT reconstructions and intra-operative findings. It respects the anatomical architecture of scapula, fracture mechanism, associated injuries to the shoulder girdle and, where appropriate, the preferred surgical approach.

• Keywords
• CT *, Classification *, Fractures *, Glenoid fossa *, Scapular *,
• MeSH
• Adult MeSH
• Fractures, Bone classification   diagnostic imaging   pathology   surgery   MeSH
• Physical Examination MeSH
• Glenoid Cavity injuries   surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Intraoperative Period MeSH
• Tomography, X-Ray Computed MeSH
• Shoulder Injuries MeSH
• Shoulder Joint diagnostic imaging   pathology   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Imaging, Three-Dimensional MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVE: The aim of this study is to determine normal glenopolar angle (GPA) values on bone specimens of the scapula and compare them with various radiological views and CT examination. MATERIALS AND METHODS: GPA values were measured on 100 mature, dry, non-paired scapulae, 20 pairs of dry scapulae, 50 AP radiographs of the shoulder, 50 Neer I views, 50 AP chest radiographs and 20 3D CT reconstructions of the scapula. RESULTS: Measurements made on bone specimens of the scapula showed an average GPA value of 42.3°; the mean absolute side-to-side difference was on average 1.6°. The average GPA measured on 50 AP shoulder radiographs was 35.9°, on Neer I views 40.6° and AP chest radiographs 37.1°, with the mean absolute side-to-side difference on average 4.9°; on 3D CT the average GPA was 43.0° and the mean absolute side-to-side difference on average 1.4°. CONCLUSION: GPA values depend on the method of measurement used. Measurements made on 3D CT reconstructions and Neer I views showed almost the same values as those measured on bone specimens. The values measured on AP shoulder views and AP chest radiographs were statistically significantly lower. Side-to-side variability (right and left) measured on 3D CT reconstructions was insignificant, and the obtained values corresponded to the values from bone specimens. Therefore, the best method to measure the GPA is a 3D CT reconstruction and an exact Neer I projection.

• MeSH
• Models, Anatomic * MeSH
• Arthrometry, Articular methods   MeSH
• Glenoid Cavity anatomy & histology   diagnostic imaging   MeSH
• Humans MeSH
• Cadaver MeSH
• Tomography, X-Ray Computed methods   MeSH
• Reference Standards MeSH
• Reproducibility of Results MeSH
• Sensitivity and Specificity MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

PURPOSE: Bilateral scapular fracture is a very rare injury. Most of these fractures result from electrical shock or epileptic seizure. We treated six patients with such injuries, all of them caused by direct violence. The aim of this study was to report on the patients and to present an overview of the cases published so far. METHODS: Between January 2011 and August 2012, we treated six patients with bilateral scapular fractures (four men and two women, age range 20-78 years). Another 11 cases were found in the literature. All cases were analysed in terms of injury mechanism, fracture pattern and the manner of diagnosis. RESULTS: Our six patients increased the total number of recorded cases to 17 and the number of patients with traumatic bilateral scapular fractures from four to ten. In five of our cases, the injuries were classified as being the result of high-energy trauma. Computed tomography (CT) examination of the affected scapulae was performed in all six cases, in five in combination with 3D CT reconstruction; in one polytraumatised female patient, only axial CT scans were obtained. In all five high-energy trauma cases, bilateral fracture of the scapular body was recorded, of which one was classified as open. Four of the 11 cases found in the literature were caused by direct violence: in six patients, the fractures resulted from muscle spasms associated with epileptiform seizure or electrical shock, and one patient suffered a pathological fracture associated with amyloidosis. The most frequently recorded fracture in all 17 patients (34 fractures) was of the scapular body, i.e. 24 fractures, followed by 12 fractures of the glenoid fossa. CONCLUSION: According to data in the literature, bilateral scapular fracture is a rare injury. One reason may be that the potential incidence is often neglected. With the increasing number of patients with polytrauma, the potential for scapular fracture should always be taken into account, together with the fact that this injury may be bilateral. Of vital importance in diagnosing these injuries is CT scanning, including 3D CT reconstructions.

• MeSH
• Adult MeSH
• Fractures, Bone diagnostic imaging   epidemiology   etiology   MeSH
• Incidence MeSH
• Middle Aged MeSH
• Humans MeSH
• Scapula diagnostic imaging   injuries   MeSH
• Tomography, X-Ray Computed MeSH
• Wounds and Injuries complications   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Spasm complications   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Review MeSH

The authors operated on 22 patients with scapular body fractures, with a mean age of 35 years. The minimal follow-up was 12 months. All patients were treated from the Judet posterior approach. The study included 14 cases of an isolated body fracture, three of scapular body fracture combined with fracture of the scapular neck and five of glenoid fossa fracture. In all 14 cases where a 3D computed tomography (CT) reconstruction was performed prior to operation, intraoperative findings corresponded to this reconstruction. In eight cases without preoperative 3D CT reconstruction, the correct type of fracture was identified in only two cases. We also identified three basic types of fractures of the lateral border of the scapula. The anatomical relationship between the glenoid fossa and scapular body, congruency and stability of the shoulder joint was achieved in all cases. The average constant score was 94.

• MeSH
• Adult MeSH
• Fractures, Bone diagnostic imaging   surgery   MeSH
• Internal Fixators MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Scapula diagnostic imaging   injuries   surgery   MeSH
• Young Adult MeSH
• Tomography, X-Ray Computed MeSH
• Postoperative Complications MeSH
• Shoulder Injuries MeSH
• Shoulder Joint physiopathology   surgery   MeSH
• Range of Motion, Articular MeSH
• Accidents MeSH
• Fracture Fixation, Internal methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH