IntroductionThe scapula has an important role in arm function. It links the upper extremity and the axial skeleton. Axial loading on the outstretched arm is the mechanism of indirect injury to the scapula. Direct trauma usually results from a direct blow or a fall. Muscular traction may cause avulsion fractures and shoulder dislocation may be associated with glenoid fractures.3 to 5 % of shoulder girdle injuries are scapular fractures [7,14]. This low incidence is caused by its great mobility and its position between the muscular layers. According to the literature, the mean age of patients who sustain scapular fractures is 35 to 45 years [1,13,18]. Associated injuries, like thoracic trauma or cervical spine fractures are common and may cause delayed diagnosis because they often require immediate attention. Scapular injury with malunion, soft tissue scarring, and muscle and nerve injury can all lead to decreased shoulder function.Anatomically, the anterior scapular surface is covered by the subscapularis muscle (Fig. 1). The serratus anterior muscle has its attachment on the anterior medial border of the scapula. On the posterior surface, the supraspinatus and the infraspinatus muscles have their attachments, whereas the trapezius muscle overlies the supraspinatus with attachments to the spine and the clavicle. The deltoid and many other muscles attach to the scapular margin ± the levator scapulae, the rhomboids, the teres major and minor, and an inconsistent latissimus attachment. The pectoralis minor, the coracobrachialis and the short head of the biceps attach to the coracoid, the long head of the biceps attaches to the superior glenoid and the triceps attaches to the inferior glenoid. The brachial plexus and axillary artery run posterior to the pectoralis minor tendon. The suprascapular nerve passes through the scapular notch, bridged by the transverse scapular ligament. The spinoglenoid notch, a gap between the acromion and the neck of the scapula, transmits the suprascapular nerve and vessels to the infraspinatus. Most shoulder function involves simultaneous humeral and scapular movements. The scapula rotates into abduction to assist the arm with forward elevation and undergoes adduction, elevation, or depression to help position the extremity.The aim of this article is to summarize the classification and treatment principles of fractures of the scapula. We used a standard medline search and included several articles that seemed to provide valuable information on this topic. A few examples of the AbstractThe aim of this article is to summarize the classification and treatment principles of fractures of the scapula. In general, a scapular fracture is classified according to the anatomic region (glenoid, glenoid neck, body, acromion, coracoid). Whereas body fractures are normally treated conservatively, displaced glenoid fractures require surgical intervention. Glenoid neck fractures are usually managed conservatively unless an associated clavicular fracture or AC-joint dislocation is present.
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