Related Experiment Video
Updated: Feb 10, 2026
A Scalable Model to Study the Effects of Blunt-Force Injury in Adult Zebrafish
Published on: May 31, 2021
Blunt traumatic scapular fractures are associated with great vessel injuries in children
Ibrahim Abd El-Shafy1, Lisa M Rosen, Jose M Prince
1From the Pediatric Trauma Center, Cohen Children's Medical Center, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York (I.A.e., J.M.P., N.G.R.); Feinstein Institute for Medical Research, Manhasset, New York (I.A.e., L.M.R., J.M.P., N.G.R.); Maimonides Medical Center, Brooklyn New York (I.A.e.); and Oklahoma University Health Science Center, Oklahoma City, Oklahoma (R.W.L.).
Insights
Pediatric patients with scapular fractures are 10 times more likely to sustain great vessel injuries (GVI). This association highlights the need for increased suspicion of GVI in children with blunt scapular fractures.
Area of Science:
- Pediatric Trauma Surgery
- Vascular Injury
- Orthopedic Trauma
Background:
- Blunt great vessel injury (GVI) in children can lead to poor outcomes if not identified early.
- Radiation reduction efforts in pediatric trauma may increase the risk of missed GVI.
- A known association exists between scapular fracture and GVI in adult blunt trauma patients.
Purpose of the Study:
- To investigate the association between scapular fracture and great vessel injury (GVI) in pediatric blunt trauma patients.
- To determine if the adult association between scapular fracture and GVI applies to the pediatric population.
Main Methods:
- Retrospective review of pediatric patients (<18 years) from the National Trauma Data Bank (2012-2014).
- Inclusion of all major thoracic vessels and carotid/jugular for GVI.
- Statistical comparison of demographics between patients with and without scapular fracture using the chi-squared test.
Main Results:
- A significant association was found between pediatric scapular fracture and GVI.
- Children with scapular fractures were 10 times more likely to have GVI (1.2%) compared to those without (0.12%, p < 0.0001).
- Commonly observed GVI included carotid artery, thoracic aorta, and brachiocephalic or subclavian artery/vein.
Conclusions:
- Blunt scapular fractures in children confer a 10-fold increased risk of GVI.
- The presence of a blunt traumatic scapular fracture warrants a high index of suspicion for significant GVI in pediatric trauma patients.
Background:
Patients with stable blunt great vessel injury (GVI) can have poor outcomes if the injury is not identified early. With current pediatric trauma radiation reduction efforts, these injuries may be missed. As a known association between scapular fracture and GVI exists in adult blunt trauma patients, we examined whether that same association existed in pediatric blunt trauma patients.
Methods:
Bluntly injured patients younger than 18 years old were identified from 2012 to 2014 in the National Trauma Data Bank. Great vessel injury included all major thoracic vessels and carotid/jugular. Demographics of patients with and without scapular fracture were compared with descriptive statistics. The χ test was used to examine this association using SAS Version 9.4 (SAS Institute, Inc, Cary, NC).
Results:
We found a significant association between pediatric scapular fracture and GVI. Of 291,632 children identified, 1,960 had scapular fractures. Children with scapular fracture were 10 times more likely to have GVI (1.2%) compared to those without (0.12%, p < 0.0001). Most common GVI seen were carotid artery, thoracic aorta, and brachiocephalic or subclavian artery or vein. Children with both scapular fracture and GVI were most commonly injured by motor vehicles (57% collision, 26% struck).
Conclusions:
Injured children with blunt scapular fracture have a 10-fold greater risk of having a GVI when compared to children without scapular fracture. Presence of blunt traumatic scapular fracture should have appropriate index of suspicion for a significant GVI in pediatric trauma patients.
Level Of Evidence:
Epidemiologic and prognostic study, level III; Therapeutic, level IV.
Related Concept Videos
01:20Traumatic Memory
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:20Anatomy of Blood Vessels
Arteries
Arteries circulate oxygenated blood from the heart, except the pulmonary artery, which transports deoxygenated blood to the lungs. Large arteries, such as the aorta,...
01:15Structure of Blood Vessels
01:07Development of Blood Vessels
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
01:14Overview of Blood Vessels
Arteries and Arterioles: Arteries are muscular and elastic vessels that primarily carry oxygenated blood from the heart to body tissues, except for the pulmonary artery, which carries deoxygenated blood. They have thick walls to withstand high pressure and contain a layer of muscle tissue, allowing them to expand or contract as...