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Long-term Functional Outcomes of Nonoperatively Treated Highly Displaced Scapular Body and Neck Fractures
Orthopedics
|March 20, 2020
Summary
Nonoperative management of severely displaced scapular body fractures can lead to good patient satisfaction and functional outcomes. This study found satisfactory long-term results with minimal loss of motion and strength in patients treated nonoperatively.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Musculoskeletal System Research
Background:
- Extra-articular scapular body fractures were historically treated non-surgically.
- Displaced glenoid neck fractures can cause significant dysfunction.
- Optimal surgical indications for scapular fractures remain debated.
Purpose of the Study:
- To evaluate the functional outcomes and patient satisfaction of nonoperative management for highly displaced scapular body fractures.
- To determine if nonoperative treatment yields satisfactory results despite significant displacement or deformity.
Main Methods:
- Retrospective review of 12 patients with severely displaced scapular body fractures (displacement >2 cm, angular deformity >45°, or glenopolar angle <22°).
- Functional outcomes assessed using Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-36 (SF-36), and American Shoulder and Elbow Surgeons (ASES) scores.
- Radiographic and CT evaluation, range of motion (ROM), strength, and complication assessment.
Main Results:
- Mean DASH score: 8.9, SF-36: 72.2, ASES: 85.9 at mean 54.1-month follow-up.
- Mean ROM: 88-99% and strength: 70-93% of the contralateral side.
- 10 of 12 patients reported excellent satisfaction; no radiographic non-unions; one surgical complication (infection) in a patient with concomitant fractures.
Conclusions:
- Nonoperative treatment of highly displaced scapular body fractures can achieve good patient satisfaction.
- Satisfactory long-term functional outcomes with only minor loss of motion and strength are achievable.
- Nonoperative management is a viable option for select severely displaced scapular body fractures.
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