Operative Techniques in the Management of Scapular Fractures

Cole, Peter A.; Dubin, Jonathan; Freeman, Gil

doi:10.1016/j.ocl.2013.04.001

Cited by 23 publications

(20 citation statements)

References 28 publications

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“…Excessive traction of these nerves by detachment of tissues during access may cause weakening of the rotator cuff. 6…”

Section: Discussionmentioning

confidence: 99%

“…Extended scapular approaches provide excellent posterior visualization, useful accessing of the body, spine, and neck of the glenoid. 6 The posterior approach described by Judet, which implies the extensive dissection of the infraspinatus muscle, has been widely used in the treatment of scapular fractures but is being replaced by less invasive variations due to the high morbidity and risk of neurovascular lesions. 5…”

Section: Introductionmentioning

confidence: 99%

“…In the posterior approach, it is important to identify and protect the suprascapular nerve (SN), which emanates from the spinoglenoid notch to innervate the infraspinatus muscle in its fossa (traction on this nerve can cause weakness of the rotator cuff and should be avoided). 6…”

Section: Introductionmentioning

confidence: 99%

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Anatomia da escápula aplicada à abordagem cirúrgica posterior: Parâmetros de segurança durante acesso ao ângulo lateral

et al. 2019

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Objective The objective of this paper was to identify safety parameters in the posterior surgical approach of the scapula through a cross-sectional cadaver study. Methods Thirteen cadaver shoulders with no history of surgery or prior musculoskeletal dysfunction, with mean age, weight, and height of 70.1 years, 61.5 kg, and 1.64 m, respectively, were dissected. The anatomic landmark of the studied pathway (infraglenoid tubercle) and its distance to the axillary and suprascapular nerves were measured. Results The mean distance between the infraglenoid tubercle (IT) and the axillary nerve (AN) was 23.8 mm, and the mean distance from the IT to the suprascapular nerve (SN) was 33.2 mm. Conclusion The posterior approach may be considered safe through the interval between the infraspinatus and teres minor. However, caution should be taken during muscle spacing because of the short distance between the fracture site and the location of the SN and AN. These precautions help to avoid major postoperative complications.

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“…Excessive traction of these nerves by detachment of tissues during access may cause weakening of the rotator cuff. 6…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anatomia da escápula aplicada à abordagem cirúrgica posterior: Parâmetros de segurança durante acesso ao ângulo lateral

et al. 2019

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“…6 Displaced glenoid fractures may result in unstable glenohumeral joints or luxation if not treated promptly and properly. 7–10 …”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Fixation of Comminuted Glenoid Fractures Using Cannulated Screws and Suture Anchors

Yuan

Qi³

et al. 2015

Medicine

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We investigate the feasibility of arthroscopic fixation of comminuted glenoid fractures using cannulated screws and suture anchors.We retrospectively review 11 cases of closed comminuted glenoid fractures treated at our institution from August 2010 to May 2013. The 11 patients, 8 males and 3 females, had a mean age of 41 years (range: 27–55 years). The mechanisms of injury were traffic accidents in 9 cases and falls from height in 2 cases. The mean time from injury to surgery was 12 days (range: 3–28 days). All glenoid fractures were confirmed on x-ray and computed tomography. The major fracture fragments were fixed with cannulated screws and the small fragments were fixed with suture anchors.All surgical wounds healed with primary closure and no complications including infection and neurovascular damage were observed. All 11 patients were followed up for a mean of 21 months (range: 14–29 months). Bone union was achieved in all patients with a mean time of 10 months. At the last follow-up, range of motion of the shoulder joint was significantly improved (P < 0.05). Both ASES scores (41.4 ± 24.9, 87.3 ± 13.8) and Rowe scores (28.2 ± 18.6, 93.2 ± 11.2) were significantly increased after the surgery (P < 0.01), indicating significantly improved function and stability of the shoulder joint.Arthroscopic fixation using cannulated screws and suture anchors is feasible for the treatment of comminuted glenoid fractures. This method is minimally invasive and provides good functional recovery with a lower risk of complications.

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“…In the past, these fracture patterns were treated exclusively through an open Judet approach. 3 Although Cole and colleagues 3,4 have described modifications to the original Judet technique that have minimized soft-tissue trauma, the technique still requires significant soft-tissue dissection, risks injury to the neurovascular structures (particularly the suprascapular nerve), has the potential for postoperative weakness and stiffness, and does not allow full direct visualization of the articular surface of the glenoid.…”

mentioning

confidence: 99%

Arthroscopic Reduction and Internal Fixation of an Inferior Glenoid Fracture With Scapular Extension (Ideberg V)

Tuman

Bishop

Abrams

2015

Arthroscopy Techniques

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Arthroscopic reduction and internal fixation of glenoid fractures have been well described, especially for glenoid rim (Bankart) fractures, as well as for scapular body fractures with extensions into the articular surface. This approach has the advantage of decreasing comorbidities associated with a standard open approach, but it can be technically challenging and may not be amenable to all fracture patterns. Arthroscopic fixation of scapular fractures incorporating a transverse pattern along the inferior aspect of the glenoid is particularly challenging because of difficulty in accessing this space. We detail the use of a posteroinferior arthroscopic portal for fracture reduction and hardware placement in a scapular fracture with inferior glenoid involvement.

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Operative Techniques in the Management of Scapular Fractures

Cited by 23 publications

References 28 publications

Anatomia da escápula aplicada à abordagem cirúrgica posterior: Parâmetros de segurança durante acesso ao ângulo lateral

Anatomia da escápula aplicada à abordagem cirúrgica posterior: Parâmetros de segurança durante acesso ao ângulo lateral

Arthroscopic Fixation of Comminuted Glenoid Fractures Using Cannulated Screws and Suture Anchors

Arthroscopic Reduction and Internal Fixation of an Inferior Glenoid Fracture With Scapular Extension (Ideberg V)

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