Evaluating the Fit of Current Anatomical Scapula Reconstruction Plates: A Study Using Fifty Scapulae

Abstract

Open Reduction and Internal Fixation (ORIF) of scapula fractures have increased in numbers recently. This is due to better functional outcomes achieved post-ORIF than non-operative management techniques. In South Africa, there is only one available supplier for anatomical contoured scapula plates used in the ORIF. This study examines the fit of these plates on the bony topology of fifty healthy scapula. It was observed that the short medial body plate performed the best in adhering to the bone topology followed by the short acromion plate. The glenoid plate and the long acromion and body plates were not adequately designed to fit their intended regions on the scapula. In conclusion, this study highlights the drawbacks in design of current commercial plates available for ORIF of scapula. Further studies are needed in order to evaluate the quantitative-fit performance of these plates on fracture scapula surfaces.

Do anatomical contoured plates address scapula body, neck and glenoid fractures? A multi-observer consensus study

“…23 In another study, the authors physically templated anatomical plates on healthy adult museum scapula specimens. 17 Despite the difference in methodologies, comparable results were obtained in our study and the previous ones. The results from the studies showed that the long lateral plate achieved a good fit along the fractures of the lateral border of the scapula.…”

“…These observations are in line with our previous findings. 17 The Ideberg type 3, 4 and 6 fractures pose the greatest challenge to the treating surgeon and in our study, as we observed that the glenoid plate offered limited screw options to adequately fix these fractures. When the fracture propagated, inferior to the spine, towards the medial border, the glenoid plate was found to be inadequate to address the fracture.…”

“…Nine investigators (five surgeons and four engineers) templated four plates on 22 scapulae on two separate occasions, one month apart. A scoring system, similar to our previous study, 17 was applied to this study where plates were defined in an ordinal scale of fit or no-fit depending on their ability to adhere around the fractured region (Table I). Templating of the plates around fracture regions was performed in a similar way to Malhas et al 18 The scoring system considered three factors:…”

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

“…The longer anterior clavicle plate was found to have a better fit around acromion spine fractures, especially the type III fractures. This conforms with our previous observation of long acromion plates having inadequate anatomical fidelity when templated against the scapula spine [17]. Since plate length and screw groove arrangements were the limiting factors for the acromion plates, we would recommend manufacturers modify their plate design to provide more options for fixing medial acromion and spine fractures.…”

“…A rating approach same as Malhas et al [16] and previously used in our study on adult museum specimen scapulae [17] was Table 1. Details about the acromion fracture types encountered in this study.…”