Fracture of the scapular body: Functional outcome after conservative treatment

Gosens, Taco; Speigner, B.; Minekus, Joanne P.J.

doi:10.1016/j.jse.2009.01.030

Cited by 48 publications

(36 citation statements)

References 20 publications

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“…When evaluating each individual scapular study related to some measurable outcome, some generalizations are noted (Table 5) [1, 3-5, 9, 12, 14-16, 19, 22]. In terms of nonoperative treatment, all the studies recorded excellent results if the fractures are minimally displaced [9,12]. With Edwards et al, approximately 25% of the fractures were displaced greater than 5 mm [9].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

Jones

Sietsema

2011

Clinical Orthopaedics &Amp; Related Research

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Background Operative indications for displaced scapular fractures have been controversial and inconsistent. Surgeons have been dissuaded to operate on these uncommon fractures because of the complex anatomy, approaches, and fracture patterns. It is unclear whether return to work, pain, or complications differ in patients with scapular fractures treated nonoperatively or operatively. Questions/Purposes We therefore assessed differences in rates of union, range of motion, ability to return to work, pain, and complications between operatively and nonoperatively treated scapular body and neck fractures. were treated with open reduction internal fixation and matched by age, occupation, and gender to 31 patients treated nonoperatively. The proportions of AO/OTA fracture types were similar in the two groups. The mean displacement, shortening, and angulation were greater in the operative group as compared with the nonoperative group. All patients were followed until healing or discharge from care (average, 1.5 years; range, 14-32 months). We assessed complications, return to work, and radiographic healing. Results All fractures healed. We found no differences in return to work, pain, or complications. Conclusions Our observations suggest operative treatment of displaced scapula fractures results in similar healing, return to work, pain, and complications as nonoperative treatment. We do not recommend operating on any scapular neck or body fractures displaced less than 20 mm. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

Jones

Sietsema

2011

Clinical Orthopaedics &Amp; Related Research

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“…According to the time frame of our search strategies, the oldest one was from 1984 and the newest from 2011. Excluded were two studies: one study because the treatment for all patients was not exactly defined (6) and one study clearly stating that only scapula body fractures were included (7).…”

Section: Resultsmentioning

confidence: 99%

A Meta-Analysis of Operative Versus Nonoperative Treatment In 463 Scapular Neck Fractures

Dienstknecht¹,

Horst²,

Pishnamaz³

et al. 2013

Scand J Surg

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Background and Aims: Treatment of scapular neck fractures remains controversial. Advantages of surgical treatments, such as anatomical restoration of fracture displacement, are counterbalanced by approach morbidity. We conducted a meta-analysis of 463 scapular neck fractures and compared clinical, functional, and radiographical outcomes in operatively and nonoperatively treated scapular neck fractures.Material and Methods: A literature search was conducted, including the databases PubMed/MEDLINE, Embase, and the Cochrane Database of Systematic Reviews. Manuscripts were included if they reported a precise description of treatment, complications, functional outcomes, and/or radiographic evaluation. Data about day-to-day activities, level of pain-freeness, range of motion, functional grading, and radiographical assessment were pooled and compared using fixed effects models.Results and Conclusions: A total of 22 manuscripts were relevant, including 1 prospective cohort study and 21 retrospective studies. The studies showed a high heterogeneity in the result assessment. Most patients had concomitant injuries. In total, 234 out of the 463 fractures were treated operatively. Pain-freeness and radiographic outcome measurements were significantly better in the operatively treated group, whereas range of motion was significantly improved in the nonoperative treated patients. Complication rate for surgical treatment was about 10%. From the achievable data, there was no bias detected when comparing the two treatment groups. However, those data could not be analyzed for all included studies. For the same reason, the role of additional surgical treatment for concomitant injuries to the shoulder girdle could not be cleared completely. Caution should be exercised, and individual injury patterns have to be taken into consideration when considering the best treatment options.

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“…Scapular fractures are uncommon (accounting for only 0,4 -1% of all bone fractures and 3 to 5% of all shoulder girdle injuries) due to the muscular coverage of the scapula and as a rule they are result of marked force applied in the course of high-velocity chest trauma (7). According to the literature data, 32 to 80% of scapular fractures are a result from traffic accidents (2, 3, 6-8).…”

Section: Discussionmentioning

confidence: 99%

Scapular fractures in blunt chest trauma – self-experience study

Novakov¹,

Traykova²,

Tchervenkov³

2016

TJS

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PURPOSE. The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries. METHODS. Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analyzed. RESULTS. Scapular fractures were caused by high energy blunt chest trauma. Body of the scapula was fractured in all scapular fractures. In all cases scapular fractures were associated with other thoracic injuries (average 3,25/per case). Rib fractures were present in eight patients, fractured clavicula -in four cases, affection of pleural cavity -in eight of the patients and pulmonary contusion in all nine cases. Eight patients were discharged from the hospital up to the 15 th day. One patient had died on the 3 rd day because of postcontusional lung edema. CONCLUSIONS. The study confirms the role of scapular fractures as a marker for the severity of the chest trauma (based on the number of associated thoracic injuries), but doesn't present scapular fractures as an indicator for high mortality in blunt chest trauma patients.

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Fracture of the scapular body: Functional outcome after conservative treatment

Cited by 48 publications

References 20 publications

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

A Meta-Analysis of Operative Versus Nonoperative Treatment In 463 Scapular Neck Fractures

Scapular fractures in blunt chest trauma – self-experience study

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