Functional outcome before and after reconstruction of extra-articular malunions of the scapula [presentation] Presentation uri icon
  • Malunion following scapula fracture is common, given that nonoperative treatment for scapula fractures is the standard of care. This condition has been assumed to eventuate in normal outcomes. Nevertheless, chronic pain, weakness, and shoulder deformity are previously reported complications in some patients with scapula malunion. The purpose of this study is to assess surgical and functional results of corrective reconstruction of malunited, extra-articular scapula fractures in patients with chronic pain, limited range-of-motion, weakness and gross deformity. Between 2000 and 2008, 5 patients underwent operative reconstruction of a malunited, scapula neck and/or body fracture. Mean time from injury to surgery was 15 months (range=8-41). All patients presented with debilitating chronic pain, weakness and were unable to return to their occupation. Surgery consisted of osteotomy and reorientation of the scapula neck, fixation using 3.5 mm implants and autogenous iliac crest graft. Pre- and postoperative motion, strength testing, and functional outcome scores were assessed. Mean follow-up was 38 months (range=13-101). Mean preoperative displacement was 3.0cm of medialization (range=1.7-4.2). All patients had united radiographically, were pain free, and expressed satisfaction with their result. Four returned to their original occupation and activities. Mean DASH score improved from 39 (range=27-58) preoperatively to 12 (range=0-44) postoperatively (normative mean=10.1). One desired removal of hardware which was performed one year postoperatively. There were no complications. Malunion following nonoperative treatment of a scapula fracture may be associated with poor functional outcomes. In select cases, operative reconstruction can yield good surgical and functional results with a high degree of patient satisfaction.

  • participant
  • Anavian, J. A.   Presenter  
  • Cole, Peter A., MD   Presenter  
  • Talbot, M.   Presenter  
  • Research
  • Orthopedics
  • Shoulder
  • Surgery