Early Results of Scapular Fractures Treated Operatively at a Level One Trauma Center

Heim, Kathryn A.; Lantry, Jacob M.; Burke, Charity S.; Roberts, Craig S.

doi:10.1007/s00068-007-7041-5

Cited by 10 publications

(3 citation statements)

References 21 publications

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“…Although there are historical reports of operative fixation of the scapula, greater interest has been shown recently in the operative treatment of severely displaced scapula fractures as more positive outcomes emerge out of surgical series. 4,12–38 This literature has indicated that displaced scapular body and neck fractures treated nonoperatively can be associated with complications and poor outcomes such as reduced range of motion, chronic shoulder pain, and concomitant injuries, highlighting the possible benefit that surgical intervention can have for these patients. 16,39–51 Understanding the patterns of fractures in the scapula may lead to improved surgical planning and execution.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Mapping of Scapular Body, Neck and Glenoid Fractures

Cole,

Schroder,

Brahme

et al. 2023

Journal of Orthopaedic Trauma

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Objectives: The purpose of this study was to report patterns of scapular fractures and define them with a contemporary methodology. Methods: Design: Retrospective study, 2015 – 2021 Setting: Single, Academic, Level 1 Trauma Center Patient Selection Criteria: Consecutive patients ≥ 18 years, presenting with unilateral scapula fracture, with thin-slice (≤ 0.5 mm) bilateral CT scans of the entirety of both the injured and uninjured scapulae Outcome Measures and Comparisons: Thin-slice (0.5 mm) computed tomography (CT) scans of injured and normal scapulae were obtained to create three-dimensional (3D) virtual models. 3D modeling software (Stryker Orthopedics Modeling and Analytics, Stryker Trauma GmbH, Kiel, Germany aka SOMA) was used to create a 3D map of fracture location and frequency. Fracture zones were delineated using anatomic landmarks to characterize fracture patterns. Results: 87 patients were identified with 75 (86%) extra-articular and 12 (14%) intra-articular fractures. The dominant fracture pattern emanated from the superior lateral border (Zone E) to an area inferior to the spinomedial angle (Zone B) and was present in 80% of extra-articular fractures. A second-most common fracture line propagated from the Primary (most-common) Line towards the inferior medial scapular border with a frequency of 36%. Bare zones (with one or no fractures present) were identified in four unique areas. Furthermore, intra-articular fractures were found to be heterogenous. Conclusions: The 3D fracture map created in this study confirmed that extra-articular scapular fractures occur in certain patterns with a relatively high frequency. Results provide greater insight into scapular fracture locations and may help to study prognosis of injury and improve treatment strategy including operative approaches and surgical tactics.

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Section: Introductionmentioning

confidence: 99%

Three-Dimensional Mapping of Scapular Body, Neck and Glenoid Fractures

Cole,

Schroder,

Brahme

et al. 2023

Journal of Orthopaedic Trauma

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“…Regrettably, surgical management, while beneficial, is limited by the concept of conservative treatment. The decision of whether to perform surgical treatment in SBFs (AO/OTA classification: 14-A2.2) remains controversial, 2,6 and there are limited data in the literature for guiding orthopaedic surgeons on deciding on the most appropriate treatment to achieve the best possible clinical outcome for the patient. Current knowledge on the outcomes of surgically treated SBFs has been derived from small and indirect comparisons.…”

Section: Introductionmentioning

confidence: 99%

“…Management of scapular body fractures (SBFs; AO/OTA classification: 14-A2.2) has most often been defined as 'benign neglect'. [1][2][3][4] Despite the assessment of the impact of 'benign neglect' by multiple studies, 1,3,[5][6][7] there is a lack of consistency regarding its effectiveness in preventing or avoiding complications, or its impact on longer-term outcomes. This controversy remains due to small sample sizes and low rates of complications induced by SBFs, which limits the power of these studies.…”

Section: Introductionmentioning

confidence: 99%

Ring versus non-ring plate for the treatment of displaced scapular body fractures: a retrospective study with a mean follow-up of 5 years

et al. 2018

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ObjectiveTo compare surgical complications and functional outcomes of the ring plate versus the non-ring plate approach to the surgical repair of scapular body fractures (SBFs; AO/OTA classification: 14-A2.2).MethodsThis retrospective study reviewed data from adults with SBFs who underwent a modified Judet approach combined with non-ring or ring plates between November 2006 and June 2013. The primary outcomes were the Constant and Murley score and the Disabilities of the Arm, Shoulder and Hand (DASH) score. The secondary outcomes were radiographic findings.ResultsA total of 318 patients had a non-ring or ring plate internal fixation, of which 147 patients (ring-treated, n = 72; non-ring-treated, n = 75) were evaluated with a mean follow-up period of 60 months. At the 3-month follow-up, the complication rate was 2.8% and 13.3% for the ring-treated and non-ring-treated groups, respectively. The difference persisted over time, with significantly different rates of 8.3% and 20.0% at the final follow-up for the ring and non-ring groups, respectively. The ring-treated group had significantly higher postoperative Constant and Murley scores and lower DASH scores compared with the non-ring-treated group.ConclusionApplication of a modified Judet approach combined with ring plate internal fixation for the treatment of SBFs may be the preferred treatment option.

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