Scapular Alignment Restoration After Posterior Fixation of Displaced Scapular Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Surgical management of displaced scapular fractures is debated, especially concerning scapular alignment restoration.
• Restoring lateral border offset (LBO) and angular deformity is crucial for optimal outcomes.

Purpose of the Study:

• To evaluate radiologic restoration and clinical outcomes after posterior fixation of displaced scapular fractures.
• To assess the impact of correcting LBO and angular deformity on surgical results.

Main Methods:

• Retrospective case series of 20 patients with displaced scapular fractures treated with posterior open reduction and internal fixation.
• Radiologic assessment (CT scans) of LBO, angular deformity, and intra-articular step-off pre- and post-surgery.
• Clinical evaluation included shoulder range of motion (ROM), DASH, and ASES scores.

Main Results:

• Significant postoperative improvements in LBO, angular deformity, and intra-articular step-off were observed.
• Mean LBO improved from 18.9 mm to 3.1 mm; angular deformity improved from 28.7° to 0.9°.
• Functional outcomes showed mean DASH score of 27.3 and ASES score of 71.6, with no negative impact from glenoid involvement.

Conclusions:

• Posterior fixation effectively restores scapular alignment and articular congruity in displaced fractures.
• Restoration of LBO and correction of angular deformity are important surgical goals for optimal scapular alignment.
• Associated ipsilateral upper extremity injuries may negatively impact functional results.