Fracture of the Supraglenoid Tubercle Treatment and Results in Five Horses

Abstract

Five horses with fractures of the supraglenoid tubercle (tuber scapulae) were presented from 6 weeks to 1 year after injury. Clinical signs included lameness characterized by a shortened cranial phase of the stride and shoulder muscle atrophy. Radiographically, the fractures differed in the degree of cranioventral displacement of the fragment as well as the extent of joint involvement. Three horses were treated by resection of the fractured tubercle, including one using a new grid approach to the area of the fracture. Two of these horses have returned to athletic activity and one was euthanized due to postoperative infection. One horse with minimal displacement and joint involvement was treated with rest and raced successfully. One horse seen with a fracture of 1 year duration also was treated with rest and was a pasture sound broodmare. NATOMICALLY, THE supraglenoid tubercle (tuberA scapulae) is the most cranial prominence of the scapula and forms the point of the shoulder. It serves as the origin of the biceps brachii muscle and the two glenohumeral ligaments that support the scapulohumeral joint capsule.' The coracoid process is the medial projection of the supraglenoid tubercle and is the origin of the coracobrachialis muscle.2 The supraglenoid tubercle and coracoid process form from a single center of ossification and fuse with the cranial portion of the glenoid cavity and the main body of the scapula at about 1 year of age ( Fig. 1).2

Supraglenoid tubercle fractures repair with transverse locking compression plates in 4 horses

“…In these cases, the end of the resected biceps tendon may functionally reattach to the scapula via fibrosis . Previous reports describe that 4 out of 7 horses treated with this technique were in work at follow‐up examination (although some at reduced level), 2 were euthanatized due to postoperative infection, and 1 was euthanatized due to postoperative caudal luxation of the scapula . In the case series reported here, surgery was delayed by 10 days in 2 cases and 42 days in 1 horse.…”

“…Although conservative management may be indicated in some cases, this approach will usually result in osteoarthritis of the scapulohumeral joint. Residual lameness should be, therefore, be expected, especially if the fracture involves the articular surface of the scapula . In one report, 5 out of 6 horses with various types of SGT fractures managed conservatively were euthanatized due to continued lameness .…”

Ultrasonographic evaluation of normal scapula in the horse

“…The image was obtained using a linear array transducer with 8-12 MHz frequency and depth was set at 62 mm. DISCUSSION Scapular fractures are rare, and most fractures involve supraglenoid tubercle which can be diagnosed by radiography (Dyson, 1985;1986;Pankowski et al, 1986;Bleyaert et al, 1994;Rooney, 1998;Kidd et al,. 2007).…”

“…Because of the appropriate protection of scapula by muscles, scapular fracture is not frequent in horse. Supraglenoid tubercle is the most common site of fracture and is usually the result of trauma (Dyson, 1985;1986;Pankowski et al, 1986;Bleyaert et al, 1994;Rooney, 1998;Kidd et al, 2007). However complete fractures of the scapular body and neck have been reported uncommonly (Bukowiecki et al, 1989;Shamis et al, 1989).…”

Fractures of the scapula

“…Apart from general chapters in textbooks (Hunt and Northrop ; Fortier ) and one report on 20 fractures in the shoulder region (Dyson ), most descriptions of scapula fractures found in the literature involve small case series of up to 5 horses (Leitch ; Pankowski et al . ; Bleyaert et al . ; Bleyaert and Madison ) and single case reports (Goble and Brinker ; Wagner et al .…”