Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases.

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Abstract

[Indexed for MEDLINE] 18. Orthop Surg. 2025 May;17(5):1349-1358. doi: 10.1111/os.70012. Epub 2025 Mar 2. Comparative Study of Trans-Axillary Approach and Delto-Pectoral Approach to the Treatment of Ideberg Types I and II Scapular Glenoid Fractures. Zhang X(1), Jiang Z(1), Chu FL(1), Jia DL(2), Han XG(1), Li XY(1), Zhao YF(1), Wang HB(1), Wu B(1). Author information: (1)Department of Trauma Orthopedics and Emergency Surgery, Affiliated Hospital of Jining Medical University, Jining, China. (2)Department of Clinical Medicine, Jining Medical University, Jining, China. OBJECTIVE: Clinically, simple glenoid fractures are less prevalent, and surgical treatment of anterior glenoid fractures is often based on the classic anterior approach (delto-pectoral approach), while there are few reports on the efficacy of the trans-axillary approach. The objective of this study is to explore the clinical efficacy of both approaches in the treatment of Ideberg Types I and II scapular glenoid fractures. METHODS: The trans-axillary approach is the surgical method of exposing a glenoid fracture along the anterior edge of the latissimus dorsi muscle through an axillary incision. In terms of the Ideberg classification of scapular glenoid fractures, 36 patients with Ideberg Types I and II scapular glenoid fractures were retrospectively analyzed. There were 22 males and 14 females, and 9 cases of traffic injuries, 6 cases of high fall injuries (> 1 m), 18 cases of fall injuries (≤ 1 m), and 3 cases of strain injuries. Meanwhile, there were 29 cases of Type Ia, 2 cases of Type Ib, and 5 cases of Type II. Based on the surgical approach, the patients were divided into the trans-axillary approach group (21 cases) and the delto-pectoral approach group (15 cases). The following data were collected: general information including age, gender, and body mass index; hospitalization time, operation time, bleeding volume; disability of the arm, shoulder, and hand (Quick DASH [QDASH]); and patient satisfaction. Comparisons between the groups were made using the t test for two independent samples. RESULTS: Operative time was significantly shorter in the trans-axillary approach group than in the delto-pectoral approach group (t = 6.39, p