Surgical Discussion

Patient positioning:  The patient was positioned laterally to optimize intraoperative imaging and access to the surgical site.

Anatomical surgical approach:  A modified Judet approach was utilized, involving an incision over the posterior aspect of the shoulder. Dissection proceeded through the deltoid and infraspinatus muscles, creating an interval between the teres minor and infraspinatus tendons. An arthrotomy was performed between these tendons to address labral delamination and facilitate reduction of the glenoid fracture.

The reduction was particularly challenging due to partial delamination and bowstringing of the labrum, complicating joint congruity restoration. Precise anatomical knowledge was crucial to avoid injury to the suprascapular nerve and artery during exposure and reduction maneuvers.

Postoperative protocol:   Postoperative rehabilitation included immobilization in a sling for initial weeks, followed by gradual passive range of motion exercises. Active range of motion and strengthening exercises were introduced progressively based on clinical and radiographic healing.

Follow up:   Not specified.

Orthopaedic implants used:   Orthopaedic implants used included plates and screws for stabilization of the glenoid and scapular body fractures.