Current challenges and controversies in the management of scapular fractures: a review

Abstract

Fractures of the scapula are rare and usually associated with high-energy trauma. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. Furthermore, the literature is controversial regarding surgical indications and rationale for treatment. The present review article was designed to address and discuss critical aspects of decision-making for the management of scapular fractures, including surgical indications and patient safety considerations.

A new surgical approach for the treatment of scapular glenoid fractures- Axillary approach: A single center case series

“…In the actual operation, we found that the ligaments and tendons around the shoulder joint were invaded greatly during the operation, whether it was through the intermuscular groove approach or the Judet approach [ 11 , 12 ]. In the treatment of scapular glenoid fractures, the intermuscular groove approach requires incision of the subscapularis tendon, and the Judet approach requires the stripping of the subscapular muscle, which causes great trauma to the soft tissues around the shoulder joint [ 13 ]. Is there a new surgical approach to solve or partially solve the above-mentioned problems?…”

Quantitative fit analysis of acromion fracture plating systems using three-dimensional reconstructed scapula fractures – A multi-observer study

“…Painless osteosynthesis of the acromion, post-surgery is very important for the functioning of rotator cuff and deltoid muscles [ 31 ]. Pires et al [ 13 ] recommended that all displaced Kuhn et al [ 32 ] classified type II and type III acromion fractures must always be treated surgically to prevent muscle weakness and provide unimpaired functioning of the shoulder joint. In our study, we observed that the clavicle plates had a similar or better fit when it came to medial acromion fractures running into the scapula spine.…”

“…Other surgeons have also reported their use of these plates for internal fixation of the acromion fractures [ 1 , 12 ] when the plate-bone congruency is not optimal [ 11 ]. It is important to note that the acromion region has attachment points deltoids and important rotator cuff muscles such as supraspinatus pass underneath it, therefore if fractures of this process are not well fixed the function of the whole shoulder complex can be compromised [ 13 ]. There are no studies in the literature that extensively investigates the performance of these plates for fractures observed in Southern Africa.…”

Isolated fracture of the coracoid’s process base 9-years after a Latarjet procedure: A novel case report

“…Coracoid fractures (CF) are relatively uncommon injuries, with an estimated incidence of 2-13% of all scapular fractures that are reported in the literature [1][2][3][4] . These usually result from high-energy trauma to the shoulder girdle and, therefore, in most cases CF are associated with other injuries, including acromioclavicular (AC) or glenohumeral dislocation, clavicular fracture, proximal humerus fracture or rotator cuff tears.…”

“…These usually result from high-energy trauma to the shoulder girdle and, therefore, in most cases CF are associated with other injuries, including acromioclavicular (AC) or glenohumeral dislocation, clavicular fracture, proximal humerus fracture or rotator cuff tears. Isolated CF are even rarely reported [1][2][3][5][6][7] . Additionally, as far to the authors knowledge, there are no reports of an isolated acute fracture of the base of the coracoid process 9-years after a Latarjet procedure.…”