Wednesday, June 19, 2013

Glenoid type - Walch classification

We are all indebted to Gilles Walch and his colleagues for pointing to the importance of glenohumeral relationships and glenoid shapes in characterizing the pathoanatomy of the arthritic shoulder. They pointed out in some arthritic shoulders the glenoid is eroded medially without posterior displacement, as in this type A2:

while in others the posterior glenoid is eroded and the humeral head is posteriorly subluxated, as in this B2 glenoid.

In practice, however, we recognize that the categories of A1, A2, B1, B2 and C do not recognize the fact that there are intermediate pathologies, such as that between A1 and B1, or that between A2 and B2. This may account for some of the interobserver variability in applying this classification to 'tweeners'. 

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