Articular and extra-articular scapula fracture

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiology

Background:

• Scapular fractures are uncommon injuries with limited high-quality evidence.
• While surgical indications are expanding, non-operative management with early rehabilitation is typically the standard of care.

Purpose of the Study:

• To outline current indications for surgical intervention in scapular fractures.
• To review treatment strategies for various scapular fracture types, including acromion and glenoid fractures.
• To emphasize the importance of evaluating the superior shoulder suspensory complex.

Main Methods:

• Review of existing literature on scapular fracture management.
• Analysis of computed tomography (CT) criteria for surgical decision-making.
• Discussion of surgical techniques and conservative treatment options.

Main Results:

• Specific CT criteria (glenopolar angle, displacement, angulation, joint involvement) guide surgical decisions for neck, body, and glenoid fractures.
• Acromion fractures, especially stress fractures post-arthroplasty, present treatment challenges; conservative care for non-displaced fractures, osteosynthesis for medial fractures.
• Surgical fixation of the clavicle or combined clavicular and scapular fixation is indicated based on scapular neck fracture displacement.

Conclusions:

• Non-operative treatment with early rehabilitation yields good results for most scapular fractures.
• Surgery for scapular fractures is technically demanding with potential complications, reserved for specific indications.
• Management of acromion fractures and assessment of the superior shoulder suspensory complex are critical for optimal outcomes.