title: A comparison of actual and theoretical treatments of glenoid fractures.
abstract: BACKGROUND
  There is no consensus on the operative treatment of glenoid fractures. The purpose of this study was to see whether there was a difference between how patients with a glenoid fracture would receive treatment according to theoretical operative indications based on the measurement of computed tomography (CT) scans and radiographs and the treatment they actually received in our institutions.
  
  
  METHODS
  A total of 457 patients with a scapular fracture were treated in two level 1 trauma centres between January 2002 and August 2011. Ninety-eight patients with a glenoid fracture were retrospectively analyzed. Intra-articular gap, medial or lateral (M/L) displacement, angular deformity, and glenopolar angle (GPA) were measured on CT scans or radiographs to determine theoretical indications for operative treatment.
  
  
  RESULTS
  Twenty-four patients (25%) actually had operative treatment, while 35 patients (36%) fulfilled at least one theoretical criterion to proceed with operative treatment with a medium correlation between theoretical indications for surgery and the actual operative treatment. All the patients with a theoretical indication for surgery had an intra-articular gap with a step-off of >4 mm. A bony Bankart lesion with shoulder dislocation and injury in sports was retained in the best multivariable model as indications for the actual surgery.
  
  
  CONCLUSIONS
  Theoretical guidelines for surgery on glenoid fractures may not have much influence on the current treatment.
  
  
  METHODS
  Therapeutic, level III.
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Mulder
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: van Suchtelen
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Gertraud
authors.initials: G
authors.lastname: Gradl
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address: dring@partners.org.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D061165:Glenoid Cavity / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017410:Practice Guidelines as Topic; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: 3D computed tomography; Glenoid fracture; Indications for surgery; Operative treatment; Radiographs