Conservative Treatment of Ipsilateral Fractures of the Scapula and Clavicle

Ramos, Luis; Mencía, R.; Alonso, A. Calles; Ferrández, L

doi:10.1097/00005373-199702000-00009

Cited by 71 publications

(36 citation statements)

References 6 publications

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“…Most can be treated conservatively with early mobilisation of the shoulder [3,12]. Although good results following this functional treatment have been reported, in patients who have a clavicular fracture combined with a scapular neck fracture or an injury to the coracoclavicular ligament, conservative treatment may give poor results, as these combined injuries are unstable due to loss of the suspensory function of the clavicle [2,4,11].…”

Section: Discussionmentioning

confidence: 99%

The treatment of double disruption of the superior shoulder suspensory complex

Kyung

Park

et al. 2002

International Orthopaedics

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treated 13 patients with double disruption of the superior shoulder suspensory complex (SSSC). The mean age of the patients was 42 (20-63) years. All patients had associated chest injuries, but there were no injuries of the brachial plexus or the peripheral nerves. Three patients, whose general condition was poor, were treated conservatively. Five underwent internal fixation of both the clavicular and scapular fractures and five of the clavicle only. We evaluated the clinical results using the Rowe Score after a minimum follow-up of 1 year. All fractures united. The average time to union was 14 weeks for clavicular and 11 for scapular fractures. There was malunion in four of five scapular fractures treated conservatively. A functionally better result was obtained in the surgical group with a mean Rowe Score of 88, compared with the conservative group whose mean score was 77. Surgical treatment for double disruption of the SSSC is a good option, allowing early rehabilitation and giving good functional results.Résumé Entre janvier 1997 et mars 2000, nous avons traité 13 malades avec une double interruption de la ceinture scapulaire. L'âge moyen des malades était de 42 (20-63) ans. Tous les malades avaient des atteintes concomitantes de la cage thoracique. Aucune lésion du plexu s brachial ou des nerfs périphériques n'a été observée. Trois malades ont eu un traitement conservateur en raison de leur état général. Cinq malades ont eu une fixation interne des fractures claviculaires et scapulaires, et cinq n'ont eu qu'une fixation de la fracture claviculaire. Après un suivi minimum d'une année nous avons évalué les résultats cliniques en utilisent le score de Rowe. Toutes les fractures ont consolidé dans un temps moyen de quatorze semaines pour les fractures claviculaires et onze semaines pour les fractures scapulaires. Pour cinq fractures scapulaires traitées sans fixation interne, il y avait quatre cals vicieux. D'après le score de Rowe un résultat fonctionnellement meilleur a été rapporté dans le groupe chirurgical (88) plutôt que dans le groupe conservateur (77). Le traitement chirurgical de la double du complexe suspenseur supérieur de l'épaule est une bonne option pour obtenir des résultats fonctionnelle ment bons.

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Section: Discussionmentioning

confidence: 99%

The treatment of double disruption of the superior shoulder suspensory complex

Kyung

Park

et al. 2002

International Orthopaedics

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“…Biomechanical data suggest fracture of the clavicle and scapula neck does not produce instability unless there is disruption of the coracoacromial and acromioclavicular ligaments or the coracoacromial and coracoclavicular ligaments [41]. However, the possible combinations of a double disruption of the SSSC are numerous and there are only small clinical series available [11,12,21,23,30,32,38]. Most of these studies examined the clinical scenario of the clavicle with a scapula neck fracture.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Nonoperatively Treated Displaced Scapular Body Fractures

Dimitroulias

Molinero

Krenk

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Displaced scapular body fractures most commonly are treated conservatively. However there is conflicting evidence in the literature regarding the outcomes owing to retrospective design of studies, different classification systems, and diverse outcome tools. Questions/purposes The functional outcome after nonoperative management of displaced scapular body fractures was assessed by change in the DASH (Disability of Arm, Shoulder and Hand) score; (2) the radiographic outcome was assessed by the change of the glenopolar angle (GPA); and (3) associated scapular and extrascapular injuries that may affect outcome were identified. Patients and Methods Forty-nine consecutive patients were treated with early passive and active ROM exercises for a displaced scapular body fracture. We followed 32 of these patients (65.3%) for a minimum of 6 months (mean, 15 months; range, 6-33 months). Mean age of the patients was 46.9 years (range, 21-84 years) and the mean Injury Severity Score (ISS) was 21.5 (range, 5-50). Subjective functional results (DASH score) and radiographic assessment (fracture union, glenopolar angle) were measured.

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“…Ramos et al relataram bons resultados em 19 pacientes com OF tratados não cirurgicamente (7) . Maris et al recomendam a fixação de ambas as fraturas da clavícula e colo da glenóide, quando ocorre desvio significante (8) .…”

Section: Discussionunclassified