On-line version ISSN 2309-8309
Print version ISSN 1681-150X
SA orthop. j. vol.7 n.3 Pretoria Jul./Sep. 2008
HR HobbsI; BR GarrettII; P SanchezIII; SJL RocheIV; BC VrettosV
IMBChB(UCT). Registrar, Department of Orthopaedic Surgery, University of Cape Town
IIMBChB(UCT). Registrar, Department of Orthopaedic Surgery, University of Cape Town
IIIMBChB(Wits), FCS(SA)Orth. Private Practice, East London
IVMBChB(UCT), FCS(SA)Orth. Consultant, Shoulder and Elbow Unit, Department of Orthopaedics, University of Cape Town
VMBChB(Zim), FRCS(Eng), FCS(SA)Orth, MMed(Orth)(UCT). Cape Town Centre for Bone and Joint Surgery, Vincent Pallotti Hospital
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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Dr SJL Roche
Fax: 027 21 532-2821
Tel: 027 21 404-5108
This article was submitted to an ethical committee for approval. The content of this article is the sole work of the authors. No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.