Scapular fracture: lower severity and mortality

Abstract

CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%). Road traffic accidents (RTAs) were the main cause of injury (73.2%; 30/41). Pedestrians accounted for 46.7% (14/30) of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%). Body fractures were the most common type of scapular fractures (80%). Eighteen patients (43.9%) had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%). Three patients (7.3%) had severe injuries (injury severity score, ISS > 16) which resulted in one death (2.4%). The majority of the patients were treated conservatively (87.8%). CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

What are the predictors of scapula fractures in high-impact blunt trauma patients and why do we miss them in the emergency department?

“…The incidence of scapula fractures range between 0.47 and 6.7% [10][11][12][13]. Contrary to our study, all previous studies were conducted among adults in the literature.…”

“…However, after the ISS was factored in, the mortality was significantly raised in the group with scapula fracture compared to the group without fracture, and this caused a 27.2% increase in the risk of mortality in patients with scapular fracture compared to controls (Table 2). The most common area of the scapula to be fractured is the body, ranging from 56 to 80%; 4.9-44% sustained fractures of the glenoid and neck of the scapula and 2-9.8% had fractures of the coracoids process and acromion [2,10,12]. Baldwin et al [7] explained that the acromion and coracoid process fractures were associated with greater rates of upper extremity injury.…”

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

“…Scapular fractures are uncommon, high-energy injuries usually with associated injuries [1,6,13,20,[25][26][27][28][29]. Because the scapula is enveloped by thick muscle, fractures heal quickly and predictably [18].…”

A rare complication after Velpeau bandage: Hemopneumothorax

“…Skapula kaslar tarafından çok iyi bir şekilde örtüldüğü için, travmalara karşı relatif bir korunmaya sahiptir. [3,4] Tüm kırıkların %1'ini, omuz bölgesi kırıklarının %5'ini teş-kil eden skapula kırıkları nadir lezyonlardır. Skapula kırıkları genelde yüksek enerjili travmalar sonucu oluşurlar ve eşlik eden yaralanma oranı yüksektir.…”

“…[5] Skapula kırıklarına %57 oranında toraks ve kafa travmasının eşlik ettiği bildirilmiştir. [3][4][5] Humerus kırıkları ise genellikle aktif genç hastalarda görülür. Kadın erkek oranı genelde eşittir ve sol taraf daha fazla etkilenir.…”