Classification of scapular body fractures.

Area of Science:

• Orthopedic surgery
• Radiology
• Biomechanics

Background:

• Scapular body fractures require a classification system that respects the bone's biomechanical architecture.
• Existing classifications may not adequately address the complex fracture patterns of the scapular body.

Purpose of the Study:

• To present a clinically oriented classification for scapular body fractures.
• To base this classification on the biomechanical pillars of the scapula using 3D CT reconstructions.

Main Methods:

• Analysis of 187 scapular body fractures from 375 total scapula fractures using 3D CT reconstructions.
• Fractures were defined as involving at least one of the scapula's pillars.
• Exclusion of marginal fractures, neck fractures, and inferior angle fractures.

Main Results:

• Three main fracture groups identified: spinal pillar only (12 cases), lateral pillar only (143 cases), and both pillars (32 cases).
• Lateral pillar fractures were further classified into two-part, three-part, and comminuted subtypes.
• Fractures involving both pillars, particularly those through the central spinal pillar, represented the most severe injuries.

Conclusions:

• A classification system based on pillar involvement is logical, simple, and respects scapular anatomy.
• 3D CT reconstruction is essential for this classification and aids in preoperative planning.
• This classification can guide therapeutic decisions for scapular body fractures.