Fixation of Displaced Lateral Column and Spine of Scapula using Modified Judet Approach

Since traumatic injuries to the scapula and scapulothoracic articulation are rare, they have not been extensively covered in the literature. According to reports, arthrosis, rotator cuff dysfunction, scapulothoracic dyskinesis, and impingement pain all contributed to decreased shoulder function after nonsurgical therapy. In addition, it was noted that surgical intervention for scapular fractures produced better results and a higher functional recovery.

A 51-year-old female presented to our emergency department with a history of a fall of a heavy object over her right shoulder. A 3D computed tomography scan of the right shoulder was performed, and it revealed an extraarticular fracture of the lateral column with significant displacement and a glenopolar angle of >40° along with a scapular spine fracture. We decided to fix the fracture using 3.5 mm contoured reconstruction plates through the modified Judet approach. The patient had good clinical function and radiological union at 8 months post-surgery.

The modified Judet approach in the open reduction and fixation offers a great exposure of the glenoid neck and lateral column fractures for fixation while causing minimal morbidity and good functional results.