Treatment of Ideberg type IV glenoid fracture via a non-dissecting and non-transected approach to the deltoid, infraspinatus, and teres minor muscles: A case report

Abstract

Introduction and importance

Scapular fractures are infrequent injuries, accounting for 0.5 % - 2.2 % of all fractures. Among these, glenoid fractures account for up to 20 % of all scapular fractures. Such fractures usually result from high - energy trauma and are an indication of severe concomitant injuries. The shoulder is enveloped by a substantial amount of muscle tissue, and there are nerve and vascular bundles in the vicinity of the glenoid. Therefore, the management of glenoid fractures is relatively intricate.

Presentation of case

We reported a 33-year-old male patient who suffered a right Ideberg type IV glenoid fracture due to a car accident. The fracture was treated with a non-transected approach to the deltoid, infraspinatus and teres minor muscles without cutting the shoulder muscles, and a small plate was used for glenoid fixation. During the follow-up period, the shoulder joint function recovered well. At the last follow-up, the fracture had healed. The forward flexion of the shoulder joint could reach 170°, the posterior extension could reach 60°, and the abduction could reach 170°. The Constant score of the shoulder joint was 91 points.

Clinical discussion

For Ideberg type IV glenoid fracture, despite the deep anatomy and the challenging nature of the treatment, our minimally invasive approach and internal fixation method, which do not cut or dissect muscles and do not damage nerves and blood vessels, have achieved excellent clinical outcomes and patient satisfaction, with no complications.

Conclusion

The treatment of Ideberg type IV glenoid fractures without the separation and cutting of the deltoid, infraspinatus and teres minor muscles does not require extensive exposure and does not damage blood vessels and nerves. This fixation method has strong theoretical feasibility and can provide a reference for clinicians.