Displaced Fractures of the Glenoid Fossa; Results of Open Reduction and Internal Fixation

Mayo, Keith A.; Benirschke, Stephen K.; Mast, Jeffrey W.

doi:10.1097/00003086-199802000-00015

Cited by 136 publications

(106 citation statements)

References 14 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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“…Surgically treated scapula fractures predominantly use a posterior surgical approach in combination with a Judet skin incision to facilitate open reduction and internal fixation [10,17,19,21,25]. Observation of the glenoid and scapula body is paramount to obtain adequate reduction and fixation of the displaced bony fragments, and excessive elevation of the infraspinatus muscle and violation of the suprascapular neurovascular bundle have been described in surgical technique manuscripts as potential risks for iatrogenic injury [6,7,19,21].…”

Section: Discussionmentioning

confidence: 99%

“…Surgically treated scapula fractures predominantly use a posterior surgical approach in combination with a Judet skin incision to facilitate open reduction and internal fixation [10,12,17,19,21,25]. Using the classic Judet posterior approach [10], the infraspinatus muscle is dissected and subsequently retracted from the infraspinatus fossa while avoiding injury to the underlying suprascapular neurovascular bundle.…”

Section: Introductionmentioning

confidence: 99%

Vulnerable Neurovasculature with a Posterior Approach to the Scapula

Wijdicks

Armitage

Anavian

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Anatomic studies have described areas where there is no direct threat of inadvertent suprascapular nerve injury; however, these studies did not describe danger zones during open reduction and internal fixation of the fractured scapula. We therefore sought to define the topographic distribution in which these vulnerable structures most commonly are found, thus establishing danger zones. Twenty-four nonpaired cadaveric specimens were dissected. The infraspinatus and teres minor musculature were elevated off the posterior scapula body to reveal critical areas where the suprascapular neurovasculature and circumflex scapular artery were vulnerable to injury. We established radial coordinates to determine this relation to osseous landmarks. The mean distance from the spinoglenoid notch to the inferior border of the danger zone was 2.4 cm (range, 1.2-3.8 cm). The mean distance from the medial extent of the scapular spine to the medial border of the danger zone was 4.3 cm (range, 3.0-6.7 cm). The entry of the ascending branch of the circumflex scapular artery was located at the lateral border 5.6 cm (range, 4.5-7.0 cm) inferior to the spinoglenoid notch. These danger zones can aid the surgeon in determining the risk for suprascapular nerve injury, specifically with scapula fractures involving the spinoglenoid notch and/or lateral border.

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“…Fractures were classified according to the revised AO/ OTA [19] and Mayo [20] classifications and included four patients with comminuted body fractures (14-A3.2), one patient with an intra-articular glenoid fracture with extension into the body (14-C3, Mayo Type IV), one patient with an extra-articular comminuted scapula neck fracture (C1.2), and one patient with an extra-articular scapula neck fracture (C1.1). Five of the seven patients had associated injuries, including rib fractures (n = 2), ipsilateral distal radius fracture (n = 1), ipsilateral distal ulna fracture (n = 1), ipsilateral metacarpal fracture(s) (n = 1), pneumothorax (n = 2), pulmonary contusion (n = 1), complex facial laceration (n = 1), traumatic brain injury (n = 1), Grade I splenic laceration (n = 1), suprascapular nerve injury (n = 1), and left midshaft femur fracture (n = 1) ( Table 1).…”

Section: Methodsmentioning

confidence: 99%

Surgical Technique: A Minimally Invasive Approach to Scapula Neck and Body Fractures

Gauger

Cole

2011

Clinical Orthopaedics &Amp; Related Research

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Background The approach of choice for open reduction internal fixation of displaced fractures involving the scapula neck or body is from posterior. We describe a new approach that minimizes the surgical insult to the soft tissues but preserves the ability to restore alignment and stability to the fracture. Description of Technique Based on the fracture pattern, incisions are made along the anatomic bony perimeter to access the scapula borders for reduction and fixation. Since the incisions are centered over sites of ''perimeter'' fracture displacement of this relatively flat bone, minimal soft tissue retraction and less muscular stripping are necessary, while indirect reduction of the intervening scapula body is accomplished to restore anatomic alignment. Patients and Methods We retrospectively reviewed seven men with a mean age of 39 years (range, 19-75 years) who underwent open reduction internal fixation of a displaced scapula body or neck fracture using this minimally invasive approach. The minimum followup was 12 months (mean, 16 months; range, 12-23 months).

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Displaced Fractures of the Glenoid Fossa; Results of Open Reduction and Internal Fixation

Cited by 136 publications

References 14 publications

The treatment of double disruption of the superior shoulder suspensory complex

The treatment of double disruption of the superior shoulder suspensory complex

Vulnerable Neurovasculature with a Posterior Approach to the Scapula

Surgical Technique: A Minimally Invasive Approach to Scapula Neck and Body Fractures

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