Bilateral scapular fractures after reverse shoulder arthroplasties

Stevens, Christopher; Murphy, Mark R.; Stevens, Taylor D.; Bryant, Tony; Wright, Thomas W.

doi:10.1016/j.jse.2014.09.045

Cited by 21 publications

(21 citation statements)

References 28 publications

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“…Reverse shoulder arthroplasty (RSA) is a common therapeutic method which has been applied to a mass of etiologies and populations. However, it is related with an enhancive number of complications and postoperative discomforts [15,20,22,56–60]. In particular, the occurrence of SS fractures has a prevalence ranging from 0.8% to 10.2% [6,13,14,16,20,22,56,58,60–68].…”

Section: Discussionmentioning

confidence: 99%

The Anatomical Variation of the Scapular Spine in A Chinese Population

et al. 2019

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BackgroundThe occurrence of fractures and risks following reverse total shoulder arthroplasty (rTSA) is common due to the variation of scapular spine (SS). Therefore, the consideration of the variable osteological features of SS prior to surgery may prove to be significant for the implementation of rTSA. This study aimed to propose a classification of SS through particular and quantitative parameters.Material/MethodsIn total, 354 intact dry scapulae were geometrical measured and classified on account of anatomical characteristics and the shapes of SS.ResultsType I SS was found, and this was the most frequency was type (27.97%). The least common type was type II. The type of SS had a direct association with bone stock and bone mineral density. Type II represented an association with a much thinner spine and restricted cortical and cancellous bone; types II and V were also associated with a crooked SS, which had a more complex morphology.ConclusionsThis study offered a comprehensive classification of SS in the Chinese population. On the whole, this study indicates that knowledge of the morphological variations of SS can prompt the diagnosis of scapular fractures and can promote more successful rTSA procedures, and the relative clinical trial is necessary to support it.

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Section: Discussionmentioning

confidence: 99%

The Anatomical Variation of the Scapular Spine in A Chinese Population

et al. 2019

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“… 100 Post-operative scapular fractures have been associated with inferior clinical results and increased risk of revision. 121 Bilateral scapular fractures 125 and clavicle stress fractures 126 after RTSA have also been reported.…”

Section: Complicationsmentioning

confidence: 98%

Reverse total shoulder arthroplasty

Familiari¹,

Rojas

Doral

et al. 2018

EFORT Open Reviews

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Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching.Current controversies in RTSA include optimal baseplate positioning, humeral neck-shaft angle (135° versus 155°), glenosphere placement (medial, lateral or bony increased offset RTSA) and subscapularis repair.Improvements in prosthesis design, surgeon experience and clinical results will need to occur to optimize this treatment for many shoulder conditions.Cite this article: EFORT Open Rev 2018;3:58–69 DOI: 10.1302/2058-5241.3.170044

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“…Implant-related fractures during the perioperative period can be due to the stress from the superior screw placement on the top of the metaglene, which may cause a type III scapular spine fracture 6, 19, 23, 31. The incidence of scapular fractures due to RTSA ranges from 0.8% to 10.2% 6, 19, 31. Post-RTSA scapular fracture can also be related to minor upper extremity trauma, such as falling onto an outstretched hand or acromial stress fracture 18 .…”

Section: Discussionmentioning

confidence: 99%

Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty

et al. 2019

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Background Indications for reverse total shoulder arthroplasty (RTSA) have expanded. The purpose of this retrospective cohort study was to evaluate national trends in shoulder arthroplasty utilization and to compare national perioperative complication rates for hemiarthroplasty (HA), total shoulder arthroplasty (TSA), and RTSA in a matched cohort. Methods The National Inpatient Sample was queried from 2011-2013 to identify patients who underwent HA, TSA, or RTSA. Age, sex, race, insurance type, Elixhauser comorbidity index, and perioperative complications were identified. A coarsened exact matching algorithm was used to match RTSA patients with TSA and HA patients to compare medical and implant-related perioperative in-hospital complications. Multivariable logistic regression analysis was performed on unmatched data to identify risk factors for development of perioperative complications. Results Overall, 42,832 shoulder arthroplasties were identified (44% TSAs, 34% RTSAs, 19% HAs). After matching, RTSAs had 6.2 times the odds of a perioperative implant-related complication ( P < .001) and 2 times the odds of a red blood cell transfusion compared with TSAs ( P < .001). The logistic regression model showed that prior shoulder arthroplasty (odds ratio [OR], 15.1; P < .001), younger age (OR, 0.98; P = .006), earlier year of index surgery (OR, 0.83; P = .002), history of illicit drug use (OR, 6.2; P = .008), and depression (OR, 2.3; P = .003) were risk factors for development of in-hospital implant-related complications after RTSA. Conclusion The perioperative implant-related complication rate and postoperative transfusion rate of RTSAs were significantly higher than those of TSAs. In addition, prior shoulder surgery, younger age, earlier year of index surgery, history of illicit drug use, and depression were risk factors for implant-related complications after RTSA. However, the perioperative RTSA implant-related complications did decline each year, suggesting a growing national proficiency with performing RTSA.

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Bilateral scapular fractures after reverse shoulder arthroplasties

Cited by 21 publications

References 28 publications

The Anatomical Variation of the Scapular Spine in A Chinese Population

The Anatomical Variation of the Scapular Spine in A Chinese Population

Reverse total shoulder arthroplasty

Reverse shoulder arthroplasty has higher perioperative implant complications and transfusion rates than total shoulder arthroplasty

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