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Are Routine Follow-up Radiographs Necessary for Extra-articular Scapula Body Fractures Managed Conservatively?
R Garrett Steinmetz1, Jeremiah J Maupin, Eric B Johnson
1From the Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma, Oklahoma City, OK.
Summary
Routine postinjury imaging for extra-articular scapula body fractures is often unnecessary and costly. Transverse fracture patterns may indicate a risk for displacement, warranting closer monitoring.
Area of Science:
- Orthopedic surgery
- Radiology
- Health economics
Background:
- Extra-articular scapula body fractures typically heal well with non-surgical treatment.
- The necessity of routine follow-up imaging for monitoring healing and alignment remains unclear.
- There is a growing need for cost-effective healthcare solutions.
Purpose of the Study:
- To determine if routine postinjury imaging changes management for extra-articular scapula body fractures.
- To assess the cost-effectiveness of routine follow-up imaging.
- To identify fracture patterns associated with displacement risk.
Main Methods:
- Retrospective review of 147 non-surgically managed extra-articular scapula body fractures (2013-2017).
- Measurement of glenopolar angle, lateral border offset, sagittal angulation, and translation on initial CT and follow-up radiographs.
- Analysis of fracture patterns, displacement, and imaging costs.
Main Results:
- No management changes occurred due to postinjury radiographs in 139 patients.
- Postinjury imaging incurred costs of $172,769.50 for 204 radiographic series.
- Transverse fracture patterns were identified as a risk factor for displacement (RR=6.5).
Conclusions:
- Routine postinjury imaging for extra-articular scapula body fractures is generally not necessary.
- Non-surgical management yields satisfactory outcomes for most of these fractures.
- Selective imaging based on fracture patterns may be more cost-effective.
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