Management of Scapula Fractures at a Level 1 Trauma Centre in the United Kingdom

Background Scapular fractures, an uncommon injury that can be brought on by a high-energy mechanism because of its proximity to the pectoral and shoulder muscles, are frequently linked to fatal injuries. This study aimed to compare surgical versus conservative treatment of scapular fractures and the results of treated patients. Methods The traumatic scapular fracture patients in this cross-sectional study (n = 391) were treated at a major trauma centre (level 1) in the United Kingdom between 2012 and 2018. Patients underwent a computed tomography (CT) scan of a scapula fracture with standard axial, coronal, and sagittal slices and a 3D reconstruction view based on an initial X-ray diagnosis. The Ideberg classification method was used to categorize all intra-articular scapular fractures. The two-tailed independent t-test was used to compare the surgical group to the traditionally conservative group. A p-value <0.05 was considered statistically significant. Results Scapular fractures were pre-dominant in males (82.09%, 321/391) with age (mean + SD) 43 + 1.23 years, and 76% (297/391) had 15 injury severity scores. Trauma with high energy was seen in 91% of cases for scapula fractures, whereas 93% were identified as polytrauma patients. The Advanced Trauma Life Support (ATLS) was performed in 92% of patients. The other injuries found were thorax (29.2%), limbs (21.2%), and spine (18.1%). A statistically insignificant (p-value = 0.135) difference was seen in the patients with surgery (EuroQol five-dimension five-level (EQ-5D-5L) score = 7.30) than nonoperative (EQ-5D-5L score = 6.14). Conclusions Based on our results, conservative management had better outcomes, but surgical options must be explored in selected cases as the difference in outcomes is not statistically significant.