Scapular body fracture and concomitant inferior angle apophyseal separation with intrathoracic displacement: a case report

Abstract

A 10-year-old patient presented to the emergency room after a motor vehicle accident. The patient was diagnosed with left scapular body fracture and concomitant inferior angle apophyseal separation with intrathoracic displacement causing hemopneumothorax. The displaced scapular body was reduced surgically and separated apophysis of the inferior angle was fixed to the scapular body with absorbable suture. Postoperative 2-year follow-up showed a good result. A literature search found two pediatric cases of intrathoracic displacement of scapular body fracture. There was no previous report of apophyseal separation of the inferior angle of the scapula.

Surgical treatment of scapular malunion combined with chest deformity after trauma: a case report

“…In all cases, fragments of the scapula or ribs caused perforating injuries that needed immediate surgical intervention. 21 The authors of a case report of comminuted scapular body fracture with a fragment perforating the subscapularis and impinging on the intercostal muscles stressed the importance of recognizing fractures with serious violation of scapulothoracic joint. Those could be considered as an indication for operation.…”

Diagnosis and Treatment of Scapular Fractures in Children and Adolescents

“…The second largest group included 34 patients (30 boys and 4 girls) with scapular body fractures with a mean age of 11 years 30,34,35,42,44,52,55,61-64,67,70,78,79 . The injury involved the infraspinous part of the scapular body in 33 cases and both pillars of the scapula (i.e., the supraspinous and infraspinous parts of the scapular body) in 1 case 84 (Fig.…”

“…There were only 3 cases of scapular body fractures that were treated surgically; an absolute indication for surgery was intrathoracic penetration of a fragment of the scapular body 55,78,79 . Internal fixation of the scapula was not performed.…”

Scapula fractures: a review

“…Angular deformity of > 45° is an example of this that has already been discussed, and for the same reason gross chest wall deformity from underlying rib fractures could come into this category and provide an indication for rib fixation. Other more unusual examples include displacement of the angle of the scapula between ribs to become intra-thoracic, 30 and displacement of segments of the blade of the scapula such that they pierce the subscapularis and project into the chest wall creating pain and limitation of movement. 31 …”