Álvarez‑Ojeda JY, Hernández‑Espino P, Guerra‑Soriano F

Language: Spanish
References: 23
Page: 265-270
PDF size: 188.16 Kb.

ABSTRACT

Introduction: Scapular fractures comprise 1% of all fractures and 3 to 5% of the shoulder, they occur in young patients by high energy trauma. Only 10% have surgical indication based on the alteration of the shoulder’s suspensory complex. The objective is to assess the outcome of patients with surgical indication as well as a review of the literature. Case report: We present two patients with Bartonicek D fracture of the right scapular body with mediolateral displacement, anteroposterior angular deformity and alteration of the glenopolar angle. Surgery was performed on both cases with conventional and special anatomical plates. Functional assessment and radiographic follow-up of both cases were performed at 6 months, obtaining flexion mobility of 180^º/170^º in both cases, as well as functional scales DASH 22/25, Constant 90/89 and Simple Shoulder Test 11/11 respectively; with bone consolidation grade III-IV of Montoya. Discussion: Due to the low degree of satisfaction with conservative treatment in patients with high functional demand, and multiple complications consisting in residual pain, impingement and scapular dyskinesia; it is important to perform an adequate reduction and stabilization of the fracture. We recommend surgical management for this type of fractures since they compromise the kinetic chain of the shoulder and impact the functional outcome in the short and medium term.

REFERENCES

1. Bartonícek, J, Cronier, P. History of the treatment of scapula fractures. Arch Orthop Trauma Surg. 2010; 130(1): 83-92. doi: 10.1007/s00402-009-0884-y.

2. Ao R, Yu B, Zhu Y, Jiang X, Shi J, Zhou J. Single lateral versus medial and lateral plates for treating displaced scapular body fractures: a retrospective comparative study. J Shoulder Elbow Surg. 2018; 27(2): 231-6. doi: 10.1016/j.jse.2017.07.028.

3. Park HY, Jin HJ, Sur YJ. Scapular body fracture and concomitant inferior angle epiphyseal separation with intrathoracic displacement: a case report. J Pediatr Orthop B. 2017; 26(5): 429-32. doi: 10.1097/BPB.0000000000000404.

4. Zuckerman SL, Song Y, Obremskey WT. Understanding the concept of medialization in scapula fractures. J Orthop Trauma. 2012; 26(6): 350-07. doi: 10.1097/BOT.0b013e3182290a34.

5. Panigrahi R, Madharia D, Das DS, Samant S, Biswal MR. Outcome analysis of intra-articular scapula fracture fixation with distal radius plate: a multicenter prospective study. Arch Trauma Res. 2016; 5(4): e36406. doi: 10.5812/atr.36406.

6. Schroder LK, Gauger EM, Gilbertson JA, Cole PA. Functional outcomes after operative management of extra-articular glenoid neck and scapular body fractures. J Bone Joint Surg Am. 2016; 98(19): 1623-30. doi: 10.2106/jbsb.15.01224.

7. Bartoníček J, Tuček M, Klika D. Inferior glenoid fossa fractures: patho-anatomy and results of operative treatment. Int Orthop. 2017; 41(9): 1741-8. doi: 10.1007/s00264-017-3511-5.

8. Cole PA, Freeman G, Dubin JR. Scapula fractures. Curr Rev Musculoskelet Med. 2013; 6(1): 79-87. doi: 10.1007/s12178-012-9151-x.

9. Bartoníček J, Kozánek M, Jupiter JB. Early history of scapular fractures. Int Orthop. 2016; 40(1): 213-22. doi: 10.1007/s00264-015-2821-8.

10. Voleti P, Namdari S, Mehta S. Review article fractures of the scapula. Ad Orthop. 2012; 2012: 903850. doi: 10.1155/2012/903850.

11. Brandsema B, Neuhaus V, Gradl G, Ring DC. Extra-articular scapular fractures: comparison of theoretical and actual treatment. Shoulder Elbow. 2016; 8(1): 3-8. doi: 10.1177/1758573215578587.

12. Lambert S, Kellam JF, Jaeger M, Madsen JE, Babst R, Andermahr J, et al. Focussed classification of scapula fractures: Failure of the lateral scapula suspension system. Injury. 2013; 44(11): 1507-13. doi: 10.1016/j.injury.2013.03.001.

13. Nekkanti S. Isolated fractures of the body of scapula. Malays Orthop J. 2013; 7(3): 24-6. doi: 10.5704/MOJ.1311.004.

14. Dimitroulias A, Molinero KG, Krenk DE, Muffly MT, Altman DT, Altman GT. Outcomes of nonoperatively treated displaced scapular body fractures. Clin Orthop Relat Res. 2011; 469: 1459-65. doi 10.1007/s11999-010-1670-4.

15. Cole PA, Gauger EM, Herrera DA, Anavian J, Tarkin IS. Radiographic follow-up of 84 operatively treated scapula neck and body fractures. Injury. 2012; 43(3): 327-33. doi: 10.1016/j.injury.2011.09.029.

16. Noguchi T, Mautner JF, Duncan SFM. Dorsal plate fixation of scapular fracture. J Hand Surg Am. 2017; 42(10): 843.e1-843.e5. doi: 10.1016/j.jhsa.2017.07.022.

17. Pizanis A, Tosounidis G, Braun C, Pohlemann T, Wirbel RJ. The posterior two-portal approach for reconstruction of scapula fractures: results of 39 patients. Injury. 2013; 44(11): 1630-5, doi: 10.1016/j.injury.2013.07.020.

18. Manohara R, Kumar V, A reverse Judet approach to the scapula. Arch Orthop Trauma Surg. 2018; 138(5): 669-73. doi: 10.1007/s00402-018-2897-x.

19. Bartoníček J, Tuček M, Fric V. Fractures of the scapular neck: diagnosis, classifications and treatment. Int Orthop. 2014; 38(10): 2163-73. doi: 10.1007/s00264-014-2434-7.

20. Uzkeser M, Emet M, Kılıç M, Işık M. What are the predictors of scapula fractures in high-impact blunt trauma patients and why do we miss them in the emergency department? Eur J Trauma Emerg Surg. 2012; 38(2): 157-62. doi: 10.1007/s00068-011-0139-9.

21. Gumina S, Carbone S, Postacchini F. Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy. 2009; 25(1): 40-45. doi: 10.1016/j.arthro.2008.08.019.

22. Kibler WB, Sciascia A. Current concepts: scapular dyskinesis. Br J Sports Med. 2010; 44: 300-5. doi: 300 10.1136/bjsm.2009.058834.

23. Kibler WB, Sciascia A, Wilkes T. Scapular dyskinesis and Its relation to shoulder injury. J Am Acad Orthop Surg. 2012; 20(6): 364-72. doi: 10.5435/JAAOS-20-06-364