Rockwood Children CH19

738

SECTION TWO • Upper Extremity

Ia

Ib

II

III

IV

Va

Vb

Vc

VI

Figure 19-11.  Schematic depicting the six types of glenoid cavity fractures.

anterior (type Ia) or posterior (type Ib) aspect of the glenoid rim. Type II fractures have a transverse fracture line that divides the superior and inferior aspects of the glenoid and then exits inferiorly through the lateral scapular border. Types III and IV fractures also begin with a fracture line dividing the superior and inferior aspects of the glenoid, but type III fractures exit superiorly near or through the scapular notch and type IV frac- tures exit medially through the medial border of the scapula. Type V fractures have more than one fracture line involving a combination of types II to IV and are further subclassified into a, b, and c. Type Va fractures are a combination of type II and IV fractures; type Vb fractures are a combination of types III and IV fractures; and type Vc fractures are a combination of types

II, III, and IV fractures. Finally, type VI fractures are severely comminuted fractures.

OUTCOME MEASURES FOR SCAPULA FRACTURES No specific outcome measures exist for the evaluation of scap- ula fractures. Results in the adult literature utilize subjective complaints of pain, fracture displacement, residual deformity, nonunion, and development of posttraumatic arthritis as deter- minants for success. 38,76,81,96,113 Specific pediatric outcomes have not been developed but the goals of outcome are the same: restoration of motion, function, and strength without long-term limitations and/or pain.