eMedicine Specialties > Orthopedic Surgery > Shoulder

Scapula Fracture: Follow-up

Author: Thomas P Goss, MD, Chief of Shoulder Surgery, Professor, Department of Orthopedic Surgery, University of Massachusetts Memorial Health Care
Coauthor(s): Robert V Cantu, MD, Staff Physician, Department of Orthopedics, University of Massachusetts Medical Center
Contributor Information and Disclosures

Updated: Dec 19, 2008

Outcome and Prognosis

Because of the low incidence of scapula fractures, little outcome data exists. Hardegger et al reported 79% good-to-excellent results associated with 5 displaced glenoid neck fractures treated surgically (6.5-year follow-up).1 Kavanaugh et al at the Mayo Clinic reviewed 10 displaced glenoid cavity fractures treated with ORIF and found it to be a useful and safe technique that can restore excellent function of the shoulder.10 Until more data are available, it is reasonable to predict a good-to-excellent functional result if surgical management restores normal or near-normal anatomy, articular congruity, and glenohumeral stability; if surgery provides secure fixation; and if a well-structured and intensive rehabilitation program is implemented.

Future and Controversies

Recognizing the exact indications for operative treatment of scapula fractures is a major issue for the future. The authors have presented guidelines for when to consider surgery. However, more data are needed to further define and support these recommendations. As surgical techniques advance, the indications for surgical intervention may expand.

 


More on Scapula Fracture

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Workup: Scapula Fracture
Treatment: Scapula Fracture
Follow-up: Scapula Fracture
Multimedia: Scapula Fracture
References
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References

  1. Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg [Br]. Nov 1984;66(5):725-31. [Medline].

  2. Tadros AM, Lunsjo K, Czechowski J, Abu-Zidan FM. Multiple-region scapular fractures had more severe chest injury than single-region fractures: a prospective study of 107 blunt trauma patients. J Trauma. Oct 2007;63(4):889-93. [Medline].

  3. Baldwin KD, Ohman-Strickland P, Mehta S, Hume E. Scapula fractures: a marker for concomitant injury? A retrospective review of data in the national trauma database. J Trauma. Aug 2008;65(2):430-5. [Medline].

  4. Ada JR, Miller ME. Scapular fractures. Analysis of 113 cases. Clin Orthop. Aug 1991;(269):174-80. [Medline].

  5. Goss TP. Scapular Fractures and Dislocations: Diagnosis and Treatment. J Am Acad Orthop Surg. Jan 1995;3(1):22-33. [Medline].

  6. Ideberg R. Unusual glenoid fractures: a report on 92 cases. 1987;58:191-2.

  7. Goss TP. Fractures of the glenoid cavity. J Bone Joint Surg [Am]. Feb 1992;74(2):299-305. [Medline].

  8. DePalma AF. Surgery of the Shoulder. 3rd ed. 1983.

  9. Soslowsky LJ, Flatow EL, Bigliani LU, Mow VC. Articular geometry of the glenohumeral joint. Clin Orthop Relat Res. Dec 1992;181-90. [Medline].

  10. Kavanagh BF, Bradway JK, Cofield RH. Open reduction and internal fixation of displaced intra-articular fractures of the glenoid fossa. J Bone Joint Surg Am. Apr 1993;75(4):479-84. [Medline].

  11. Nordqvist A, Petersson C. Fracture of the body, neck, or spine of the scapula. A long-term follow- up study. Clin Orthop. Oct 1992;(283):139-44. [Medline].

  12. Goss TP. Double disruptions of the superior shoulder suspensory complex. J Orthop Trauma. 1993;7(2):99-106. [Medline].

  13. Herscovici D Jr, Fiennes AG, Allgower M. The floating shoulder: ipsilateral clavicle and scapular neck fractures. J Bone Joint Surg [Br]. May 1992;74(3):362-4. [Medline].

  14. Burke CS, Roberts CS, Nyland JA, Radmacher PG, Acland RD, Voor MJ. Scapular thickness--implications for fracture fixation. J Shoulder Elbow Surg. Sep-Oct 2006;15(5):645-8. [Medline].

  15. Lantry JM, Roberts CS, Giannoudis PV. Operative treatment of scapular fractures: a systematic review. Injury. Mar 2008;39(3):271-83. [Medline].

  16. Zlowodzki M, Bhandari M, Zelle BA, Kregor PJ, Cole PA. Treatment of scapula fractures: systematic review of 520 fractures in 22 case series. J Orthop Trauma. Mar 2006;20(3):230-3. [Medline].

  17. Butters KP. The scapula. In: The Shoulder. Vol 1. 1990:335-66.

  18. Goss TP. Fractures of the glenoid neck. J Shoulder Elbow Surg. 1994;3:42-52.

  19. Goss TP. Glenoid fractures: Open reduction internal fixation. In: Master Techniques in Orthopaedic Surgery. 1998:3-17.

  20. Goss TP. The scapula: coracoid, acromial, and avulsion fractures. Am J Orthop. Feb 1996;25(2):106-15. [Medline].

  21. Miller ME, Ada JR. Fractures of the scapula, clavicle, and glenoid. In: Skeletal Trauma: Fractures, Dislocations, Ligamentous Injuries. Vol 2. 1992:1291-1310.

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Further Reading

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Keywords

scapula fracture, glenoid fracture, acromion fracture, coracoid fracture, scapulothoracic dissociation, double disruption of the superior shoulder suspensory complex

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Contributor Information and Disclosures

Author

Thomas P Goss, MD, Chief of Shoulder Surgery, Professor, Department of Orthopedic Surgery, University of Massachusetts Memorial Health Care
Thomas P Goss, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Massachusetts Medical Society, and Orthopaedic Trauma Association
Disclosure: Nothing to disclose.

Coauthor(s)

Robert V Cantu, MD, Staff Physician, Department of Orthopedics, University of Massachusetts Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Lynn A Crosby, MD, FACS, Chief of Shoulder Division, Professor, Department of Orthopedic Surgery, Wright State University School of Medicine
Lynn A Crosby, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American College of Surgeons, American Fracture Association, American Medical Association, American Medical Tennis Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Arthroscopy Association of North America, Mid-America Orthopaedic Association, and Orthopaedic Research Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Pekka A Mooar, MD, Professor, Department of Orthopedic Surgery, Temple University School of Medicine
Pekka A Mooar, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Mary Ann E Keenan, MD, Professor, Vice Chair for Graduate Medical Education, Department of Orthopedic Surgery, University of Pennsylvania School of Medicine; Chief of Neuro-Orthopedics Program, Department of Orthopedic Surgery, Hospital of the University of Pennsylvania
Mary Ann E Keenan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, American Society for Surgery of the Hand, and Orthopaedic Rehabilitation Association
Disclosure: Nothing to disclose.

 
 
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