Spontaneous scapular spine fracture related to rotator cuff pathology: a report of two cases

Groot, Diederik; Giesberts, Anouk M. E.; Mourik, J. B. A. van

doi:10.1007/s11751-012-0135-6

Cited by 13 publications

(21 citation statements)

References 8 publications

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“… 17 , 18 The cause of indirect trauma is the violent voluntary contraction of muscles and ligaments attached to the SS, often related to stress events with coughing, cuff-tear arthropathy, work-related activities, or sporting activities such as baseball, golf, or football. 19 – 21 SS mal-union has been shown to reduce subacromial space and alter normal kinematics of the acromioclavicular and scapulothoracic joints. However, these can be corrected with subacromial opening osteotomy of the SS.…”

Section: Introductionmentioning

confidence: 99%

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Classification and Morphological Parameters of the Scapular Spine

et al. 2015

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Incidence of scapular spine (SS) fractures as a result of complications of reverse total shoulder arthroplasty is relatively high leading to inferior clinical outcomes and an increased risk of revision and dislocation. Fractures of SS because of trauma, including the acromion, constitute 6% to 23% of scapula fractures. The purpose of this study was to classify the SS and present specific geometrical parameters according to osteologic features. A total of 319 intact dry scapulae were collected and classified based on morphological characteristics and shape of the SS. Nine bony landmarks were also chosen and described for their relevance to regions of interest for scapular fixation. Five specific types of SS were noted and the most prevalent groups were Type 1 (Fusiform shape) (47.17%) and Type 5 (Horizontal S-shape) (19.18%). Overall, Types 3, 4, and 1 showed thicker landmark values compared to Type 5, with Type 2 having smaller values. Our classification into 5 distinct types allowed appreciation of the anatomical variance of SSs. The contours of Types 5 and 1 presented a more complex morphology and may lead to a worse surgical approach due to a fracture. As Types 2 and 5 were much thinner than the other types, these may be more susceptible to fractures.

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Section: Introductionmentioning

confidence: 99%

“… 25 Surgical management for SS fracture is recommended especially in young, fit, and active patients. 17 – 21 During these surgical procedures, detailed knowledge of SS is fundamentally important to minimize overlying tissue irritation, aid in fracture reduction, and improve the mechanics of the bone–plate construct.…”

Section: Introductionmentioning

confidence: 99%

Classification and Morphological Parameters of the Scapular Spine

et al. 2015

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“…These stress fractures are somewhat more difficult to explain when they occur in non-weight bearing zones such as the arms. Nontraumatic fractures of the scapula are indeed a rare entity; most of the cases reported concern patients taking long-term corticosteroid therapy, as was the case here, and who are also osteoporotic and on BP therapy; in these cases, the fracture is combined with rotator cuff tendinopathy [9]. Another case concerned an osteopenic patient with Cushing's disease who presented with multiple fractures [10]; and finally, two cases concerned scapula fatigue fractures [11,12].…”

Section: Discussionmentioning

confidence: 83%

“…Concomitant treatments such as corticosteroids and comorbidities, for instance inflammatory rheumatism, may play a role, since rheumatoid arthritis is a known risk factor for stress fractures [13]. It may also be the combination of all three parameters that is responsible [9]. A diagnosis of simple stress fractures is also possible, particularly in the case of our first and third patient.…”

Section: Discussionmentioning

confidence: 94%

Atypical Insufficiency Fractures Associated with Long-Term Bisphosphonate Therapy: 3 Case Reports

Guinamand

2015

Journal of Bone Biology and Osteoporosis

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Atypical femoral fractures as defined by the American Society for Bone and Mineral Research (ASBMR) are linked with long-term bisphosphonate therapy. We report the cases of 3 patients treated with bisphosphonates, and presenting non femoral atypical fracture. Our first patient presented with a series of fractures after being treated with risedronate: the left tibia, bilateral tibial plateau successively, the left femoral and tibial metaphysis, the right tibia and calcaneus, the left talus, and the left talar dome. The second patient had been taking alendronate and presented with a spontaneous fracture of the spine of the left scapula. The third patient had been treated with alendronate and presented with a fracture of the upper right tibial diaphysis with an unusual oblique orientation. These fractures could be suggestive of bisphosphonate therapy failure or stress fractures. However, the number of fractures in our first case, the fracture site in the second and the fracture line orientation in the third brings to mind the hypothesis of atypical non femoral fractures associated with bisphosphonate therapy. We therefore suggest the possibility of a new type of atypical fracture in patients treated with bisphosphonates, and whose causal relationship with bisphosphonates is even more difficult to demonstrate.

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“…Stress fractures of the acromion or the scapular spine were previously uncommon and were found to be related to cuff-tear arthropathy, work-related activities, or sporting activities such as baseball, golf, or football. [14][15][16][17][18] Recently, the occurrence of such fractures has increased considerably as a result of complications of reverse total shoulder arthroplasty. 19,20 Because of the worldwide application of this procedure, even stress fractures confined to the scapular spine medial to the spinoglenoid notch are becoming common.…”

Section: Casementioning

confidence: 99%

Incomplete Avulsion Fractures of the Scapular Spine Caused by Violent Muscle Contraction

2013

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Two percent of scapular fractures occur as a result of indirect trauma caused by traction of the muscles and ligaments attached to the scapula. We present two cases involving adults with incomplete avulsion fractures of the scapular spine caused by violent voluntary contraction of the deltoid muscle. These cases are the first reported avulsion fractures confined to the scapular spine medial to the spinoglenoid notch. Although the fractures were incomplete, one patient had a typical symptom of scapular fracture - pseudo-rupture of the rotator cuff characterized by clinical signs of a complete rupture of the musculotendinous cuff. Although this symptom is generally thought to be caused by massive hemorrhaging under the rotator-cuff muscle bellies, it may develop from modest bleeding through the formation of an intramuscular hematoma and a resultant elevation in intramuscular pressure. Confirming the presence of tenderness on the scapular spine and performing appropriate imaging investigation constitute a clinically effective method for preventing misdiagnosis.

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Spontaneous scapular spine fracture related to rotator cuff pathology: a report of two cases

Cited by 13 publications

References 8 publications

Classification and Morphological Parameters of the Scapular Spine

Classification and Morphological Parameters of the Scapular Spine

Atypical Insufficiency Fractures Associated with Long-Term Bisphosphonate Therapy: 3 Case Reports

Incomplete Avulsion Fractures of the Scapular Spine Caused by Violent Muscle Contraction

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