Complex Scapulothoracic Disruption Managed with Scapular Dual Column Plating and Acromion Tension Band...

Area of Science:

• Orthopedic surgery
• Trauma management
• Biomechanics

Background:

• Scapulothoracic disruptions with associated scapular and acromial fractures are rare and complex injuries.
• Limited guidance exists for the combined surgical management of these severe shoulder instabilities.
• Restoring biomechanics through anatomical reconstruction is crucial for function.

Observation:

• A 43-year-old male with high-energy trauma presented with type 1 scapulothoracic disruption and fractures of the scapula and acromion.
• Surgical management included dual-column plate fixation for the scapula and tension band osteosynthesis for the acromion.
• The patient underwent a structured postoperative rehabilitation program.

Findings:

• Excellent radiological union was achieved postoperatively.
• The patient experienced full functional recovery, returning to all activities within 4 months.
• Dual-column plating ensured stable scapular reconstruction and acromial fixation facilitated deltoid reattachment.

Implications:

• Anatomical fixation is vital for restoring scapulothoracic and glenohumeral mechanics.
• This combined surgical approach offers a favorable outcome for rare, complex injury patterns.
• Biomechanically sound surgical constructs coupled with guided rehabilitation are key to optimal recovery.