Combined Glenoid and Humeral Head Reconstruction with Allografts: A Report of Two Cases and the Midterm Outcomes.

CASE: We present two cases of anterior glenohumeral instability in which both the humeral head and the glenoid were reconstructed concurrently with use of allografts; we discuss the midterm outcomes at four and one-half and five years of follow-up, respectively. CONCLUSION: In our experience, concomitant glenoid and humeral head allograft reconstruction for anterior glenohumeral instability with severe combined humeral head and glenoid pathology yielded good midterm clinical, functional, and radiographic outcomes. This treatment approach may be a viable option for young and active patients presenting with severe combined glenoid and humeral pathology and warrants additional investigation.

Intra-articular scapular fractures: Outcomes after internal fixation.

BACKGROUND: Although operative treatment may offer an appropriate management option for displaced glenoid fractures, there is sparse research assessing post-operative functional outcomes. This study assessed functional outcomes of patients after undergoing open reduction and internal fixation of displaced glenoid fractures. METHODS: Fifteen patients were treated with open reduction and internal fixation for displaced intra-articular fractures between 2005 and 2010. The indication for operative fixation was intra-articular displacement >4 mm. Post-operative functional outcomes were assessed via retrospective chart review. Evaluation included review of pre-operative imaging for fracture type, review of post-operative plain radiographs for fracture healing, Disabilities of the Arm Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeon Assessment (ASES) scores at last follow-up. RESULTS: At a mean follow-up of 49 months (24-87 months) all patients had radiographic healing. The mean DASH score was 10 (range 0.83-29.17). Mean ASES score was 90 (range 41.7-100). No patients had evidence of hardware failure or infection. CONCLUSIONS: Open reduction and internal fixation of displaced intra-articular glenoid fractures results in stable fixation and is associated with good functional outcome. LEVEL OF EVIDENCE: Level IV. Case series.