Results of non-operative treatment of fractures of the glenoid fossa

Aims Our aim was to investigate the outcomes of patients with a displaced fracture of the glenoid fossa who are treated conservatively. There is little information in the literature about the treatment of these rare injuries non-operatively. Patients and Methods We reviewed 24 patients with a mean age of 52 years ( 19 to 81) at a mean of 5.6 years ( 11 months to 18 years) after the injury. Results At final follow-up, the mean Constant and Murley score was 79 points ( 18 to 98); the mean Western Ontario Shoulder Instability Index score ( WOSI) was 77% ( 12 to 100) and the mean Rowe score was 93 points ( 50 to 100). Fractures with little intra-articular displacement (<= 3 mm) had an uneventful outcome. Those with intra-articular displacement of <= 3 mm had a significant better mean Constant and Murley score than those with displacement of >= 5 mm and/ or a fracture gap of >= 5 mm. Poor clinical results such as nonunion and post-traumatic osteoarthritis were associated with displaced or angulated glenoid fragments and significant intra-articular displacement. Conclusion Glenoid fossa fractures with displacement of >= 5 mm should be treated surgically if the patient's condition allows. Displacement and angulation can lead to nonunion and a poor outcome if the degree of displacement results in a persistent fracture gap in the glenoid fossa or if the angulation of fragments leads to malunion.