Radiographic follow-up of 84 operatively treated scapula neck and body fractures

Cole, Peter A.; Gauger, Erich M.; Herrera, Diego A.; Anavian, Jack; Tarkin, Ivan S.

doi:10.1016/j.injury.2011.09.029

Cited by 87 publications

(67 citation statements)

References 38 publications

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“…In addition to 11 previously published cases in adults (Table 2), we found another three cases reported in small children [18][19][20] and five cases found during archaeological excavations [21]. Some studies dealing with injuries of the scapula mention bilateral fractures, but give no detailed description [12,13,17,21,22].…”

Section: Discussion and Literature Overviewmentioning

confidence: 49%

Bilateral scapular fractures in adults

Tuček¹,

Bartoníček²,

Novotny³

et al. 2013

International Orthopaedics (SICOT)

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Purpose Bilateral scapular fracture is a very rare injury. Most of these fractures result from electrical shock or epileptic seizure. We treated six patients with such injuries, all of them caused by direct violence. The aim of this study was to report on the patients and to present an overview of the cases published so far. Methods Between January 2011 and August 2012, we treated six patients with bilateral scapular fractures (four men and two women, age range 20-78 years). Another 11 cases were found in the literature. All cases were analysed in terms of injury mechanism, fracture pattern and the manner of diagnosis. Results Our six patients increased the total number of recorded cases to 17 and the number of patients with traumatic bilateral scapular fractures from four to ten. In five of our cases, the injuries were classified as being the result of high-energy trauma. Computed tomography (CT) examination of the affected scapulae was performed in all six cases, in five in combination with 3D CT reconstruction; in one polytraumatised female patient, only axial CT scans were obtained. In all five high-energy trauma cases, bilateral fracture of the scapular body was recorded, of which one was classified as open. Four of the 11 cases found in the literature were caused by direct violence: in six patients, the fractures resulted from muscle spasms associated with epileptiform seizure or electrical shock, and one patient suffered a pathological fracture associated with amyloidosis. The most frequently recorded fracture in all 17 patients (34 fractures) was of the scapular body, i.e. 24 fractures, followed by 12 fractures of the glenoid fossa. Conclusion According to data in the literature, bilateral scapular fracture is a rare injury. One reason may be that the potential incidence is often neglected. With the increasing number of patients with polytrauma, the potential for scapular fracture should always be taken into account, together with the fact that this injury may be bilateral. Of vital importance in diagnosing these injuries is CT scanning, including 3D CT reconstructions.

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Section: Discussion and Literature Overviewmentioning

confidence: 49%

Bilateral scapular fractures in adults

Tuček¹,

Bartoníček²,

Novotny³

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Cole et al [2] described a variation in operative indications based on articular step-off ranging from 2 to 10 mm. Other studies suggest nonoperative treatment if the fracture is minimally displaced without defining displacement [1,5]. It seems for the most part that glenoid fractures are only operated on if they are associated with an instability of the glenohumeral joint.…”

Section: Discussionmentioning

confidence: 99%

“…AP and Y radiographs were used when CTs were not available. Theoretical operative indications were classified according to the radiographic criteria by Cole et al as follows: intra-articular gap with a step-off of !4 mm and 25% glenoid involvement, !20 mm M/L displacement (lateral border offset), !458 of angular deformity on a scapular-Y radiograph (angulation), the combination of angulation of !308 plus M/L displacement of !15 mm, and a GPA of 228 (Table 2) [5].…”

Section: Methodsmentioning

confidence: 99%

“…The purpose of this study was to determine whether there was a difference between the theoretical treatment of glenoid fractures according to the radiographic guidelines described by Cole et al [5] and the treatment they actually received in our institutions. Secondary analyses evaluated patient and radiographic factors associated with actual and theoretical operative treatments.…”

Section: Introductionmentioning

confidence: 96%

“…A study by Cole et al [5] described radiographic thresholds for operative treatment in patients with a fracture of the scapula including intra-articular gap with a step-off of !4 mm and 25% glenoid involvement, !20 mm medial or lateral (M/L) displacement, !458 of angular deformity, the combination of angulation of !308 plus M/L displacement of !15 mm, and a glenopolar angle (GPA) of 228. These recommendations are debated.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of actual and theoretical treatments of glenoid fractures

Mulder

Suchtelen

Menendez

et al. 2015

Injury

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Comparison of 2 versus 3 dimensional fracture mapping strategies for 3 dimensional computerized tomography reconstructions of scapula neck and body fractures

Dugarte

Tkany

Schroder

et al. 2017

Journal Orthopaedic Research

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Fracture mapping has been used in the understanding of injury patterns in different bones. To our knowledge, there are no applications of this technique using three-dimensional (3D) morphologic fracture characteristics. Previously, scapula fractures were mapped by transferring information from 3D computed tomography to a two-dimensional (2D) template. Cole et al. determined that 3D Computerized Tomography (CT) scans were more reliable compared to plain radiographs in terms of scapular angulation, translation, and glenopolar angle measurements. Thus, we hypothesized that if there is a difference between fracture lines drawn in 3D and in 2D, then the 3D mapping would yield more accurate fracture patterns. We completed a retrospective, comparative study (evidence level III) utilizing CT imaging from a single center scapular registry. We studied ten patients with scapula fractures in whom bilateral CT scans were obtained. Fractures were mapped both two and three-dimensionally, and we measured deviations between the fracture lines that were drawn with each approach. The measured deviations ranged from 10.4 mm to 28.0 mm when comparing 2D versus 3D techniques, with the mean deviation being 4.0 mm and 10.4 mm, respectively. Half of the 2D renderings possessed hidden fracture lines that were later revealed on 3D imaging. Three-dimensional renderings were more accurate when compared to 2D fracture mapping methods. This more accurate technique will allow for better understanding of 3D morphology and provide a basis for future fracture mapping in any bone. Accurate mapping is important because surgical approach, reduction, fixation, and implant design and selection are based on fracture patterns. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:265-271, 2018.

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Radiographic follow-up of 84 operatively treated scapula neck and body fractures

Cited by 87 publications

References 38 publications

Bilateral scapular fractures in adults

Bilateral scapular fractures in adults

A comparison of actual and theoretical treatments of glenoid fractures

Comparison of 2 versus 3 dimensional fracture mapping strategies for 3 dimensional computerized tomography reconstructions of scapula neck and body fractures

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