Osteosynthesis of scapular fractures: a retrospective cohort study

Arch Orthop Trauma Surg. 2022 Dec;142(12):3845-3852. doi: 10.1007/s00402-021-04283-3. Epub 2022 Jan 7.

Abstract

Purpose: In recent years a trend from conservative to operative treatment of displaced scapula fractures has evolved. The aim of this study was to assess surgical and patient-based radiological and functional outcome after open reduction and internal fixation (ORIF) of displaced scapula fractures following predefined operative indications.

Methods: We retrospectively analyzed data of a consecutive series of patients with displaced scapula fractures following operative fixation at our institution between 06/2010 and 02/2020. The primary endpoint was a functional outcome using the QuickDASH score. Secondary outcomes were the Subjective Shoulder Value (SSV), numeric rating scale (NRS) for pain, Activities of Daily Living score (ADL) and complications.

Results: Twenty-six male patients were treated operatively. Twenty-three of whom were available for follow-up after a median follow-up time of 33 months (interquartile range [IQR] 8-70 months). In 18 (69%) cases a standard open approach and in 8 (31%) cases a minimal invasive (MI) approach was used. The median QuickDASH was 0 (IQR 0-0) with a median SSV of 95 (IQR 90-98). Patients reported a median NRS of 0 (IQR 0-1) and a median ADL score of 1 (IQR 1-1). Radiological fracture union was 100% without the occurrence of implant failure or mal-union. Two patients (7.7%) required early correction osteosynthesis, one patient (3.8%) developed a frozen shoulder 3 months postoperatively, and one patient (3.8%) presented with a superficial wound infection.

Conclusion: Following previously published indications for ORIF of displaced scapula body and neck fractures a good functional outcome and a low rate of complications could be achieved.

Keywords: Floating shoulder; Osteosynthesis; Scapula fracture; Shoulder girdle; Superior shoulder suspensory complex.

MeSH terms

  • Activities of Daily Living
  • Fracture Fixation, Internal / adverse effects
  • Fractures, Bone* / diagnostic imaging
  • Fractures, Bone* / etiology
  • Fractures, Bone* / surgery
  • Humans
  • Male
  • Retrospective Studies
  • Scapula / surgery
  • Shoulder Fractures* / complications
  • Thoracic Injuries* / complications
  • Treatment Outcome