Scapular fractures

Scapular fractures

1. Scapular fractures Puneet Monga Consultant Orthopaedic Shoulder Surgeon

2. Structure Image courtesy- Google Images

3. Mechanism Commonly associated with Chest, spine, clavicle, abdominal and pelvic injuries

4. Classification A Fractures of the body of scapula B. fractures of the process B1 spine B2 coracoid B3 acromion C Fractures of scapular neck C1 anatomical neck C2 surgical neck C3 surgical neck with D. Articular fractures D1 glenoid rim D2 glenoid fossa with a. inferior glenoid fragment b. horizontal split of scapula c. coracoglenoid block formation d. comminuted fractures D3 scapula neck and body fracture E. Fracture combination with humeral head fractures Euler and Rüedi

5. Classification Ideberg

6. The floating shoulder Superior shoulder suspensory complex

7. Management Guidelines A Fractures of the body of scapula Euler and Rüedi Risk of malunion - rib friction Risk of non union

8. Management Guidelines B. fractures of the process B1 spine B2 coracoid B3 acromion Euler and Rüedi Displaced? Will it Heal

9. Management Guidelines C Fractures of scapular neck C1 anatomical neck C2 surgical neck C3 surgical neck with Euler and Rüedi Shortening? Loss of RC length /tension

10. Management Guidelines D. Articular fractures D1 glenoid rim D2 glenoid fossa with a. inferior glenoid fragment b. horizontal split of scapula c. coracoglenoid block formation d. comminuted fractures D3 scapula neck and body fracture Euler and Rüedi Articular surface disruption? Instability?

11. Management Guidelines E. Fracture combination with humeral head fractures Euler and Rüedi Is the SSSC disputed?

12. Surgical Approach

13. Posterior Approach

14. Pre-contoured Plates

15. Case 1

16. MR

17. Arthroscopic repair

18. Case 2

19. Challenges Raising Awareness for early diagnosis and referral Management of associated injuries Look for stability of the anterior and posterior “strut”