Functional outcomes after operative management of extra-articular glenoid neck and scapular body fractures uri icon

abstract

  • BACKGROUND: This study's purpose was to assess patient-based functional outcomes following open reduction and internal fixation (ORIF) of displaced scapular body and glenoid neck fractures. This series represents a 9-year experience at a level-I trauma center and referral destination for this injury. METHODS: A database was established to record surgical and functional outcomes of scapular fractures treated with ORIF. For this report, the cases of all patients who had a glenoid neck or scapular body fracture (AO/OTA 14-A3 or 14-C1) without intra-articular involvement were reviewed. Operative indications included medial/lateral displacement of >/=20 mm, angulation of >/=45 degrees , medial/lateral displacement of >/=15 mm with angulation of >/=30 degrees, double disruptions of the superior shoulder suspensory complex with both displaced >/=10 mm, a glenopolar angle of /=2 operative indications. Of the 61 patients, 49 (80%) were followed for >/=1 year (mean, 33 months; range, 12 to 138 months) following surgery. There was a 100% union rate at the time of final follow-up, with a mean DASH score of 12.1 points (range, 0 to 54 points). For all parameters, the mean SF-36 scores of the study patients were comparable with normative population scores. The range of motion of the operatively treated and contralateral shoulders averaged, respectively, 154 degrees and 159 degrees of forward flexion, 106 degrees and 108 degrees of abduction, and 66 degrees and 70 degrees of external rotation. The strength of the operatively treated and contralateral shoulders averaged, respectively, 20 and 23 lb (89.0 and 102.3 N) of force in forward flexion, 14 and 16 lb (62.3 and 71.2 N) in abduction, and 19 and 23 lb (84.5 and 102.3 N) in external rotation. Complications and/or secondary surgery were recorded for 8 patients (16%). CONCLUSIONS: Displaced scapular body and glenoid neck fractures that meet current published standards for ORIF can be treated operatively with predictably good functional outcomes.

publication date

  • 2016