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Scapular fractures

The document discusses scapular fractures, including their classification, mechanisms of injury, management guidelines, surgical approaches, challenges, and two case examples. Scapular fractures can be classified based on the location of the break, including the body, processes, neck, or articular surface. They often occur with other injuries to the chest, spine, or shoulders. Treatment depends on factors like displacement, risk of malunion, and whether the fracture disrupts the shoulder's stability. Surgery may involve plates, posterior or anterior approaches, and arthroscopic repair. Managing associated injuries and assessing stability of the scapula present challenges.

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@shoulderpedia Scapular fractures Puneet Monga Consultant Orthopaedic Shoulder Surgeon
Structure Image courtesy- Google Images
@shoulderpedia Mechanism Commonly associated with Chest, spine, clavicle, abdominal and pelvic injuries
@shoulderpedia Classification A Fractures of the body of scapula B. fractures of the process B1 spine B2 coracoid B3 acromion C Fractures of scapular neck C1 anatomical neck C2 surgical neck C3 surgical neck with D. Articular fractures D1 glenoid rim D2 glenoid fossa with a. inferior glenoid fragment b. horizontal split of scapula c. coracoglenoid block formation d. comminuted fractures D3 scapula neck and body fracture E. Fracture combination with humeral head fractures Euler and Rüedi
@shoulderpedia Classification Ideberg
@shoulderpedia The floating shoulder Superior shoulder suspensory complex
@shoulderpedia Management Guidelines A Fractures of the body of scapula Euler and Rüedi Risk of malunion - rib friction Risk of non union
@shoulderpedia Management Guidelines B. fractures of the process B1 spine B2 coracoid B3 acromion Euler and Rüedi Displaced? Will it Heal
@shoulderpedia Management Guidelines C Fractures of scapular neck C1 anatomical neck C2 surgical neck C3 surgical neck with Euler and Rüedi Shortening? Loss of RC length /tension
@shoulderpedia Management Guidelines D. Articular fractures D1 glenoid rim D2 glenoid fossa with a. inferior glenoid fragment b. horizontal split of scapula c. coracoglenoid block formation d. comminuted fractures D3 scapula neck and body fracture Euler and Rüedi Articular surface disruption? Instability?
@shoulderpedia Management Guidelines E. Fracture combination with humeral head fractures Euler and Rüedi Is the SSSC disputed?
@shoulderpedia Surgical Approach
Posterior Approach
Pre-contoured Plates
Case 1
MR
Arthroscopic repair
Case 2
@shoulderpedia Challenges • Raising Awareness for early diagnosis and referral • Management of associated injuries • Look for stability of the anterior and posterior “strut”