Development of a 3D Printing and Virtual Reality Workflow for Glenoid Fracture Preoperative Planning: A Scoping Review and Preliminary Survey of Surgeons

Glenoid fractures pose a significant challenge for preoperative planning because their complex, comminuted three-dimensional anatomy is incompletely represented by conventional two-dimensional computed tomography (CT). This study aimed to (i) map the evidence on three-dimensional (3D) printing and virtual/augmented reality (VR/AR) for glenoid fracture and related shoulder surgical planning, (ii) assess the technical feasibility of an institutional CT-to-3D-print and CT-to-VR workflow, and (iii) explore preliminary surgeon perceptions. A scoping review was conducted using Joanna Briggs Institute methodology and reported according to PRISMA-ScR. PubMed, Scopus, Web of Science, IEEE Xplore, and Cochrane Library were searched for English-language studies published from 2010 to 2026. Following duplicate removal and dual-reviewer screening, 20 sources were charted narratively. An institutional workflow was also developed and piloted using anonymised DICOM data with 3D Slicer, Meshmixer, Blender, and Unity. In addition, a 25-item anonymous survey was distributed to 20 orthopaedic clinicians, with eight responses (40%); open-text responses were analysed using template analysis. The evidence comprised cadaveric experiments, case reports/series, retrospective and comparative studies, technical feasibility studies, narrative reviews, and systematic reviews, with generally low-to-moderate methodological certainty. Reported benefits included improved implant positioning, reduced planning or operative time, enhanced anatomical understanding, and educational value. The institutional workflow was technically feasible but encountered print fragility in thin, comminuted regions, and dimensional accuracy was not formally validated. Six respondents (75%) perceived improved understanding of fracture morphology, while five (62.5%) had never personally used 3D printing or VR. Qualitative responses highlighted enhanced spatial understanding, planning confidence, educational and collaborative benefits, cost and accessibility barriers, and preference for selective rather than routine use. Overall, current evidence and preliminary clinician feedback support the feasibility and perceived value of 3D printing and VR in glenoid fracture planning; however, the evidence base remains immature. Rigorous dimensional validation and adequately powered clinical outcome studies are required before routine clinical adoption can be recommended.