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Kiritsis NR, Reiter CR, Satalich JR, Protzuk O, O'Neill CN, Vanderbeck JL. Risk factors and incidence of short-term complications following open reduction and internal fixation of scapula fractures. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024:10.1007/s00590-024-04045-y. [PMID: 39039171 DOI: 10.1007/s00590-024-04045-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE To determine the short-term complication rates following open reduction and internal fixation of scapula fractures, factors affecting the development of adverse events, and complication rates based on the anatomic location of the fracture. METHODS Thirty-day complication rates for patients who underwent open reduction and internal fixation of the scapula were compared between glenoid, body, coracoid, and acromion fracture locations, as identified by International Classification of Disease codes. Possible adverse events included postoperative surgical site infection, renal insufficiency, intubation, pneumonia, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound dehiscence, stroke, and blood transfusion. RESULTS A total of 251 scapula fractures were identified, with 161 having known fracture locations: 105 glenoid, 20 body, 9 coracoid, and 27 acromial fractures. The rate of any adverse event for all scapular fractures was 2.0%, with no significant difference between anatomic locations (p = 0.79). The overall rates of transfusion, surgical site infection, and return to OR were 0.4%, 0.8%, and 3.98%. Steroid use associated with a significantly increased risk of any adverse event (OR: 55.57, p = 0.038) and outpatient status demonstrated a protective effect on reoperation (OR: 0.11, p = 0.014). There were no significant differences in the rates between groups [transfusion (p = 0.91); surgical site infection (p = 0.17); reoperation (p = 0.85)]. CONCLUSION Complication rates within thirty days of ORIF for scapula fracture were low. Reoperation was the most common complication, followed by surgical site infection, wound dehiscence, stroke, transfusion, and pneumonia. Steroid use was a risk factor for developing any adverse event, and outpatient status was protective against reoperation. The 30-day complication profile of glenoid, body, coracoid, and acromial fractures was not significantly different. The low complication rates support the relative short-term safety of operative intervention with internal fixation. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Nicholas R Kiritsis
- Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Charles R Reiter
- Virginia Commonwealth University School of Medicine, 1000 E Marshall St, Richmond, VA, 23298, USA
| | - James R Satalich
- Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, 1200 E Broad St, 9th Floor, Box 980153, Richmond, VA, 23298, USA
| | - Omar Protzuk
- Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, 1200 E Broad St, 9th Floor, Box 980153, Richmond, VA, 23298, USA
| | - Conor N O'Neill
- Department of Orthopaedic Surgery, Duke University Health System, 2301 Erwin Rd, Durham, NC, 27710, USA
| | - Jennifer L Vanderbeck
- Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, 1200 E Broad St, 9th Floor, Box 980153, Richmond, VA, 23298, USA
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Xiang F, Xiao Y, Wei D, Tan X, He S, Luo L, Yang Y. Finite element analysis of a novel anatomical locking plate for scapular neck fracture. J Orthop Surg Res 2023; 18:262. [PMID: 37004037 PMCID: PMC10067195 DOI: 10.1186/s13018-023-03743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVES Reconstruction plates (RPs) are commonly used in scapular neck fractures (SNFs): however, RPs have many defects. In this study, we evaluated a newly designed scapular neck anatomical locking compression plate (SNALCP). METHODS An SNF finite element model (Miller-type IIB) was constructed. Plates were subsequently implanted into the scapula and fixed with screws that were grouped according to the plate used: SNALCP (A) and RP (B). Finally, loads were applied to record and analyze performance. RESULTS Under lateral, anteroposterior, and vertical compression loads, the maximum von Mises stresses on the scapula and implants of group A were smaller than those of group B. There were some differences in stress distribution between the two groups. CONCLUSIONS SNALCP can effectively reduce the stress of the scapula and implant, making stress distribution more uniform and continuous, and has mechanical conduction advantages. Compared to RP, it provides improved stability and more reliable fixation.
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Affiliation(s)
- Feifan Xiang
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, 646000, China
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
| | - Yukun Xiao
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, 646000, China
| | - Daiqing Wei
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, 646000, China
| | - Xiaoqi Tan
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Siyuan He
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Liang Luo
- Department of Joint Surgery, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, 401121, China.
| | - Yunkang Yang
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
- Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, 646000, China.
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Medial and lateral dual plating of native distal femur fractures: a systematic literature review. OTA Int 2023; 6:e227. [PMID: 36760659 PMCID: PMC9904193 DOI: 10.1097/oi9.0000000000000227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 10/02/2022] [Indexed: 01/18/2023]
Abstract
Introduction Lateral locked plating (LLP) development has improved outcomes for distal femur fractures. However, there is still a modest rate of nonunion in fractures treated with LLP alone, with higher nonunion risk in high-energy fractures, intra-articular involvement, poor bone quality, severe comminution, or bone loss. Several recent studies have demonstrated both the safety and the biomechanical advantage of dual medial and lateral plating (DP). The purpose of this study was to evaluate the clinical outcomes of DP for native distal femoral fractures by performing a systematic review of the literature. Methods Studies reporting clinical outcomes for DP of native distal femur fractures were identified and systematically reviewed. Publications without full-text manuscripts, those solely involving periprosthetic fractures, or fractures other than distal femur fractures were excluded. Fracture type, mean follow-up, open versus closed fracture, number of bone grafting procedures, nonunion, reoperation rates, and complication data were collected. Methodologic study quality was assessed using the Coleman methodology score. Results The initial electronic review and reverse inclusion protocol identified 1484 publications. After removal of duplicates and abstract review to exclude studies that did not discuss clinical treatment of femur fractures with dual plating, 101 potential manuscripts were identified and manually reviewed. After final review, 12 studies were included in this study. There were 199 fractures with average follow-up time of 13.72 months. Unplanned reoperations and nonunion occurred in 19 (8.5%) and 9 (4.5%) cases, respectively. The most frequently reported complications were superficial infection (n = 6, 3%) and deep infection (n = 5, 2.5%) postoperatively. Other complications included delayed union (n = 6, 3%) not requiring additional surgical treatment and knee stiffness in four patients (2%) necessitating manipulation under anesthesia or lysis of adhesions. The average Coleman score was 50.5 (range 13.5-72), suggesting that included studies were of moderate-to-poor quality. Conclusions Clinical research interest in DP of distal femoral fractures has markedly increased in the past few decades. The current data suggest that DP of native distal femoral fractures is associated with favorable nonunion and reoperation rates compared with previously published rates associated with LLP alone. In the current review, DP of distal femoral fractures was associated with acceptable rates of complications and generally good functional outcomes. More high-quality, directly comparable research is necessary to validate the conclusions of this review.
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Michelitsch C, Kabelitz N, Frima H, Kabelitz M, Beks R, Stillhard PF, Sommer C. Osteosynthesis of scapular fractures: a retrospective cohort study. Arch Orthop Trauma Surg 2022; 142:3845-3852. [PMID: 34993604 DOI: 10.1007/s00402-021-04283-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/27/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE In recent years a trend from conservative to operative treatment of displaced scapula fractures has evolved. The aim of this study was to assess surgical and patient-based radiological and functional outcome after open reduction and internal fixation (ORIF) of displaced scapula fractures following predefined operative indications. METHODS We retrospectively analyzed data of a consecutive series of patients with displaced scapula fractures following operative fixation at our institution between 06/2010 and 02/2020. The primary endpoint was a functional outcome using the QuickDASH score. Secondary outcomes were the Subjective Shoulder Value (SSV), numeric rating scale (NRS) for pain, Activities of Daily Living score (ADL) and complications. RESULTS Twenty-six male patients were treated operatively. Twenty-three of whom were available for follow-up after a median follow-up time of 33 months (interquartile range [IQR] 8-70 months). In 18 (69%) cases a standard open approach and in 8 (31%) cases a minimal invasive (MI) approach was used. The median QuickDASH was 0 (IQR 0-0) with a median SSV of 95 (IQR 90-98). Patients reported a median NRS of 0 (IQR 0-1) and a median ADL score of 1 (IQR 1-1). Radiological fracture union was 100% without the occurrence of implant failure or mal-union. Two patients (7.7%) required early correction osteosynthesis, one patient (3.8%) developed a frozen shoulder 3 months postoperatively, and one patient (3.8%) presented with a superficial wound infection. CONCLUSION Following previously published indications for ORIF of displaced scapula body and neck fractures a good functional outcome and a low rate of complications could be achieved.
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Affiliation(s)
- Christian Michelitsch
- Department of Surgery, Division of Trauma Surgery, Cantonal Hospital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
| | - Nina Kabelitz
- Department of Surgery, Division of Trauma Surgery, Cantonal Hospital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland
| | - Herman Frima
- Department of Trauma Surgery, Northwest Hospital Group, Alkmaar, Netherlands
| | | | - Reinier Beks
- Department of Trauma Surgery, Northwest Hospital Group, Alkmaar, Netherlands
| | - Philipp F Stillhard
- Department of Surgery, Division of Trauma Surgery, Cantonal Hospital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland
| | - Christoph Sommer
- Department of Surgery, Division of Trauma Surgery, Cantonal Hospital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland
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Graafland M, van de Wall BJM, van Veelen NM, van Leeuwen R, Hoepelman RJ, Knobe M, Link BC, Babst R, Beeres FJP. Long-term follow-up of patients with displaced scapular fractures managed surgically and non-operatively. Injury 2022; 53:2087-2094. [PMID: 35184818 DOI: 10.1016/j.injury.2022.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Controversy remains on which patients with displaced scapula fractures benefit from surgery. This retrospective cohort study aims to compare and describe long-term patient-reported outcomes of patients with displaced scapula fractures treated both surgically and conservatively. METHODS This study included patients with intra- and extra-articular scapula fractures, treated between 2010 and 2020 in a Swiss level 1 trauma centre. The decision to operate was based on standardized criteria for fracture displacement. Patients with isolated Bankart lesions (Ideberg 1) and process fractures (AO type 14-A) were excluded. Primary outcomes were functional patient reported measures (DASH score) and quality of life (EQ5D score). Secondary outcomes were complications, radiological union, satisfaction with treatment, pain and range of motion. RESULTS Out of 486 cases, 74 patients had displaced scapula fractures. Forty patients were treated surgically and 34 were treated conservatively. Significantly more patients with intra-articular fractures and high-energy trauma were treated surgically. Fifty percent returned the questionnaires after a mean follow-up of 47 months (± SD 36). The mean DASH score of this group was 12 (SD 15.6), with a mean of 14.7 (SD 15.9) in the surgery group and 9.8 (SD 14.6) in the non-operative group (p = 0.7). Multivariate analysis did not show statistically significant correlating factors. No significant differences in quality of life were observed. Patients rated their treatment with a mean of 8.6/10 (SD 1.8). Among surgically treated patients, 19 underwent a deltoid sparing procedure with significant shorter time to union than those that underwent deltoid release (23 vs. 49 weeks, p<0.01). Complications occurred in 3/28 surgically treated patients and all three required a reoperation. CONCLUSION In this cohort, functional results after conservative and surgical treatment were similar, despite more complex fractures and more intra-articular fractures being treated surgically. Osteosynthesis of both intra- and extra-articular scapula fractures is safe and leads to good functional results, furthermore, new minimal invasive techniques may lead to faster bone healing and return to work and sports.
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Affiliation(s)
- M Graafland
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland; Dept. of Trauma Surgery, Maasstad Hospital, Rotterdam, the Netherlands
| | - B J M van de Wall
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland; Dept. Health Science and Medicine, University of Lucerne, Switzerland
| | - N M van Veelen
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland
| | - R van Leeuwen
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland
| | - R J Hoepelman
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland
| | - M Knobe
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland
| | - B C Link
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland
| | - R Babst
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland; Dept. Health Science and Medicine, University of Lucerne, Switzerland
| | - F J P Beeres
- Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland.
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Chen J, Zhang W, Pang G, Meng Q, Zhu Y, Deng X. Influence of coracoglenoid space on scapular neck fracture stability: biomechanical study. BMC Musculoskelet Disord 2022; 23:30. [PMID: 34983487 PMCID: PMC8728935 DOI: 10.1186/s12891-021-04974-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background The anatomical variation of the coracoglenoid space has the potential to influence the stability of scapular neck fractures. This paper aimed to investigate the mechanical mechanism underlying the influence of different coracoglenoid space types on scapular neck fractures by morphometric analysis and biomechanical experiments. Methods The morphology of 68 dried scapulae (left: 36; right: 32) was studied. Two variables, the length of the coracoglenoid distance (CGD) and the coracoglenoid notch (CGN), were measured. The distribution of CGN/CGD × 100% was used to identify the morphology of the coracoglenoid space. Each specimen was tested for failure under static axial compression loading. The average failure load, stiffness, and energy were calculated. Results Two coracoglenoid space types were identified. The incidence of Type I (‘‘hook’’ shape) was 53%, and that of Type II (‘‘square bracket’’ shape) was 47%. The CGD and CGN were significantly higher for type I than type II (13.81 ± 0.74 mm vs. 11.50 ± 1.03 mm, P < 0.05; 4.74 ± 0.45 mm vs. 2.61 ± 0.45 mm, P < 0.05). The average maximum failure load of the two types was 1270.82 ± 318.85 N and 1529.18 ± 467.29 N, respectively (P = 0.011). The stiffness and energy were significantly higher for type II than type I (896.75 ± 281.14 N/mm vs. 692.91 ± 217.95 N/mm, P = 0.001; 2100.38 ± 649.54 N × mm vs. 1712.71 ± 626.02 N × mm, P = 0.015). Conclusions There was great interindividual variation in the anatomical morphology of the coracoglenoid space. Type I (hook-like) spaces bore lower forces, were less stiff, and bore less energy, which may constitute an anatomical predisposition to scapular neck fractures.
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Affiliation(s)
- Junfeng Chen
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China
| | - Wei Zhang
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China
| | - Gang Pang
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China
| | - Qingling Meng
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China
| | - Youyu Zhu
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China
| | - Xuefei Deng
- Department of Anatomy, Anhui Medical University, Hefei, 230032, China.
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Rollo G, Huri G, Meccariello L, Familiari F, Çetik RM, Cataldi C, Conteduca J, Giaracuni M, Bisaccia M, Longo D, Giannotti PS. Scapular body fractures: Short-term results of surgical management with extended indications. Injury 2021; 52:481-486. [PMID: 32951918 DOI: 10.1016/j.injury.2020.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/12/2020] [Accepted: 09/13/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Scapular body fractures represent less than 1% of all skeletal fractures. Operative criteria and risk factors for scapular fracture instability are well defined. Non-operative management of scapular body fractures show satisfactory results but with shortening and medialization of the scapular body. The aim of this study is to evaluate if surgical treatment will result in an improved quality of life and shoulder function compared to non-operative treatment on patients suffering from a scapular body fracture. MATERIALS AND METHODS From a total of 381 retrospectively identified scapular body fractures, we included 45 patients. The enrolled patients were divided into two groups: the surgical treatment (ST, n = 20) group and the non-operative treatment (NOT, n = 25) group. The Non-Union Scoring System (NUSS) was used to assess bone healing on radiographs. The functional evaluation of the two groups during the follow-up were performed using the Constant Shoulder Score (CSS) and the Quick Disabilities of the Arm, Shoulder and Hand Score (QuickDASH). Complications, reoperation rates, and time until bony union were also documented. The minimum follow-up for this study was designated as 12 months. RESULTS The ST group had better mean CSS and QuickDASH scores compared to the NOT group at 1, 3 and 6 months of follow-up. No statistically significant difference was detected at 12 months follow-up. ST group also demonstrated improved results in time until bone union, reduction of rehabilitation time, complications and return to work rates. CONCLUSION This study suggests that surgical treatment for extraarticular scapular fractures can achieve better short-term functional outcomes (3 to 6 months) compared to conservative treatment.
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Affiliation(s)
- Giuseppe Rollo
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy
| | - Gazi Huri
- Department of Orthopaedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey
| | - Luigi Meccariello
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy.
| | - Filippo Familiari
- Department of Orthopedics and Traumatology, Villa del Sole Clinic, Catanzaro, Italy
| | - Rıza Mert Çetik
- Department of Orthopaedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey
| | - Carlo Cataldi
- Department of Orthopedics and Traumatology, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Jacopo Conteduca
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy
| | - Marco Giaracuni
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy
| | - Michele Bisaccia
- Department of Surgical and Biomedical Science, Orthopaedics and Traumatology Unit, S.M. Misericordia Hospital, University of Perugia, Sant'Andrea delle Fratte, Perugia, Italy
| | - Damiano Longo
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy
| | - Prof Stefano Giannotti
- Department of Orthopedics and Traumatology, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
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Zyskowski M, Pesch S, Greve F, Wurm M, von Matthey F, Pfeiffer D, Felix S, Buchholz A, Kirchhoff C. Concomitant Intra-Articular Glenohumeral Lesions in Fractures of the Scapula Body. J Clin Med 2020; 9:jcm9040943. [PMID: 32235465 PMCID: PMC7230789 DOI: 10.3390/jcm9040943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Scapula body fractures are rare injuries with an incidence of 1% of all fractures accounting for 3% to 5% of all upper extremity fractures. Fractures of the scapula commonly result from high-energetic trauma and fall from great height. While several studies focused on concomitant injuries of chest and head as well as the cervical spine, up to now in the common literature, no study exists analyzing the prevalence of concomitant intra-articular glenohumeral injury following extra-articular scapular fracture. Objectives: The aim of this study was to analyze the prevalence of concomitant intra-articular glenohumeral injuries in acute fractures of the scapula by performing magnetic resonance imaging (MRI) of the shoulder joint. Study Design and Methods: This prospective cohort study was performed at our academic Level I trauma center from November 2014 to October 2016. According to our clinical algorithm, all patients suffering from an acute scapula body fracture primarily underwent computed tomography (CT) for assigning the fracture according to the Orthopedic Trauma Association (OTA)-classification and therapy planning. In addition, 3 T MRI-scans of all patients were performed within seven days after trauma. Results: Twenty-one (16 male/5 female, mean age 53 years (25–83 y) patients with scapula body fractures (OTA 14.A3.2 80.1%, OTA 14.A3.1 4.8%, OTA14.B3.1 4.8%, OTA14.C3 9.5%) were enrolled. MRI revealed 11 acute intra-articular injuries in 8 of 21 patients (38%). In all 21 patients, hematoma of the rotator cuff and periarticular muscles was present. Three patients (14.3%) presented a partial bursa sided tear of the supraspinatus tendon, whereas in 5 (23.8%), a partial articular sided supraspinatus tendon tear and in 2 (9.5%) patients, a subtotal tear was observed. One patient (4.8%) showed a complete transmural supraspinatus tendon tear. Conclusions: Traumatic concomitant glenohumeral injuries in scapula body fractures seem to be more frequent than generally expected. Subsequent surgical treatment of these formerly missed but therapy-relevant injuries may increase functional outcome and reduce the postoperative complication rate following scapula body fractures.
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Affiliation(s)
- Michael Zyskowski
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Sebastian Pesch
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Frederik Greve
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Markus Wurm
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Francesca von Matthey
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Daniela Pfeiffer
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Strahlentherapie und Radiologie, Ismaninger Str. 22, 81675 München, Germany;
| | - Sophie Felix
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Arne Buchholz
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
| | - Chlodwig Kirchhoff
- Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Unfallchirurgie, Ismaninger Str. 22, 81675 München, Germany; (M.Z.); (S.P.); (F.G.); (M.W.); (F.v.M.); (S.F.); (A.B.)
- Correspondence: ; Tel.: +49-89-4140-5100
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