Resumo

HOBBS, HR et al. Open reduction and internal fixation of scapula fractures. SA orthop. j. [online]. 2008, vol.7, n.3, pp.8-15. ISSN 2309-8309.

Scapular fractures requiring surgery are relatively rare injuries. This retrospective review looks at the outcome of open reduction and internal fixation of these fractures and the surgical exposures necessary for their fixation. All surgically treated scapular fractures from January 2000 to December 2006, with the exception of Ideberg type Ia (anterior rim) fractures of less than 25% with an associated dislocation, had their clinical notes and radiology reviewed. The surgical approach was analysed with regard to the fracture classification and exposure. Reduction, union and failure of fixation were assessed. Outcomes were determined with respect to pain and range of movement. At an average follow-up of 9 months (range 6 to 72 months), all of the fractures had united. Twenty out of the 25 patients were pain-free (80%) and the rest only had mild pain. Twenty-two patients (88%) had a good or functional range of movement. Adequate reduction was obtained in all but one fracture. A good outcome can be expected in over 80% of scapular fractures requiring surgical fixation. Union is predictable and the complication rate is low. Most of the fractures can be addressed by employing teres minor/infra-spinatus intermuscular planes or subscapularis muscle splits without rotator cuff tenotomies.

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