Fractures of the scapula and glenoid occur infrequently, often as a result of high-energy trauma. Patients with such fractures should be carefully evaluated because associated injuries are common and may be life threatening. Treatment is dictated by fracture displacement and glenohumeral stability. Most fractures are minimally displaced and amenable to nonsurgical treatment. Open reduction and internal fixation of intraarticular fractures are considered when the patient has glenohumeral subluxation secondary to fracture or intraarticular displacement greater than 5 mm. Treatment of extraarticular fractures is more controversial. Some authors have reported good functional results with nonsurgical management, but others advocate intervention when fracture displacement is greater than 1 cm or glenoid angulation is greater than 40 degrees. When surgical intervention is considered, strict adherence to the principles of osteosynthesis and early mobilization is necessary to optimize shoulder function.
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