Page Views: 7,752. In certain cases, surgery to repair a broken scapula is necessary. 2018 Jan. 36 (1):265-271. X-rays of your lungs and both scapulas may also be taken. Scapulothoracic Dissociation. Anatomy The scapula is a flat triangular bone with several distinct regions (Fig. Most usually with scapula fractures do understand well. … Scapular Fractures are commonly distinguished by where the fracture occurs: Glenoid cavity; Neck of the scapula; Body of the scapula; The latter are the most frequent. Scapular body fractures are most commonly encountered, accounting for 50 to 60% of scapular fractures in most series. Most people who talk about a shoulder fracture are describing a fracture of the proximal humerus. Closed fracture of left scapula; Left scapula (shoulder blade) fracture; ICD-10-CM S42.102A is grouped within Diagnostic Related Group(s) (MS-DRG v 39.0):. Most commonly the body of the scapula is involved and nonoperative management remains the mainstay of treatment for these fractures [].As these patients are usually high-demand young adults, it is important to ensure treatment will have a … angle of scapula. Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The minimal follow-up was 12 months. 5 Scapular fractures have … The approach and the positioning of the patient are determined by the exact location of the fracture. Scapular body fractures represent less than 1% of all skeletal fractures [6, 12, 24] and generally occur secondary to high-energy, direct trauma to the shoulder sustained during motor vehicle accidents [9, 10, 12].While high-energy mechanisms have been well described for scapular body fractures, little literature exists on scapular body fractures sustained during … Fractures can be divided into regions: Scapula body +/- spine. Generally, this type of fracture is not common as … The front of the scapula (acromion) is also connected to the clavicle (collarbone) through the acromioclavicular joint. @shoulderpedia Mechanism Commonly associated with Chest, spine, clavicle, abdominal and pelvic injuries. Intraarticular glenoid fractures are classified by the Ideberg Classification. body, glenoid, acromion, coracoid) The majority of fractures are treated non-operatively. Furthermore, the literature is controversial regarding surgical indications and rationale for treatment. A fracture of the scapular neck is the second most common fracture type, which typically occurs due to a direct trauma such as a fall onto the shoulder, or a fall on the outstretched arm. involved at least … Scapular Neck Fractures are second most common. Fractures of the scapula are most often caused by direct trauma from the back or side. Fractures of the scapula are relatively uncommon. Fractures of the scapula are rare and usually associated with high-energy trauma. Clavicle Fracture (Broken Collarbone) A broken collarbone is also known as a clavicle fracture. Introduction. You may be given contrast liquid to help a fracture show up better in pictures. Upper Extremity. “Epidemiology of scapular fractures. The … Scapular body (50% to 60% of patients) Scapular neck (25% of patients) Glenoid; Acromion; Coracoid When a scapular body fracture is surgically stabilized, a lateral approach is made over the spine of the scapula. N2 - Fractures of the scapula and glenoid occur infrequently, often as a result of high-energy trauma. Operative Fixation of Extra-articular Scapula Body Fracture Through a Modified Judet Approach. It always requires a 3D CT reconstruction, including subtraction of the surrounding bones. Occasionally the scapular body fracture can be palpated by pushing onto the scapular region and in doing so elicit some crepitation sounds. Closed reduction. Use the sling for the first three weeks to allow the soft tissues to settle. Home. The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. This injury is a traumatic disruption of the scapula from the posterior chest wall. Fractures that occur in the scapular body are the type most likely to be accompanied by other injuries; other bony and soft tissue injuries accompany these fractures 80–95% of the time. PY - 1999/11/30. Try not to aggravate it. When the scapula is fractured, other injuries such as abdominal and chest trauma are automatically suspected. All fractures were the results of a high impact motor vehicle accident—seven extraarticular body of scapular fracture, and three extraarticular neck of scapular fracture. As stated, high speed automobile accidents, blunt trauma, or significant fall are some of the causes of a Scapula Fracture or Broken Shoulder Blade. The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. AU - Stover, Michael. (1-4) Currently, 99% of all isolated scapular body fractures are being treated non-operatively with an immobilizing sling or brace and some form of manual therapy with an 86% success rate. This is a very common fracture that occurs in people of all ages. We will analyze scapular fractures as a group for functional outcomes and compare the outcomes of scapular body against glenoid neck fractures. The thinness of the scapular body results in difficulty in finding purchase for surgical implants; thus, minimally displaced or non-displaced fractures are treated by cage confinement. Brown C, Elmobdy K, Raja AS, Rodriguez RM. Scapular fractures are uncommon and require a large amount of force to fracture. 15 The supraspinatus and infraspinatus muscles are … Fractures specific to the scapular body comprise 35-65% of these fractures. Scapular body stress fracture: a case report. Acad Emerg Med. The clavicle lies Scapula Fractures. We will also attempt to correlate the degree of osseous derangement of a fracture as measured on radiographs with the scores on the 3 respective outcome measures and clinical extremity testing. Typical physical examination findings may include swelling, ecchymosis, crepitus, and tenderness about the shoulder. CT studies are helpful for fracture characterization and for surgical planning. They are classified according to the portion of bone involved (i.e. The articulations between the bones of the shoulder make up the shoulder joints.The shoulder joint, also known as the glenohumeral joint, is the major joint of the shoulder, but can more … Fractures specific to the scapular body comprise 35–65% of these fractures. muscles contractions, and so enhancing stress on the lower [4] Roy N, Smith MG, Jacobs LGH. [Shannon, 2019] Intra-articular involvement is rare. Usually the larger 13-hole plates are ideal for most males and the 9-hole plates are best for smaller patients. 20 Scapular neck fractures occur in about 25% of cases, followed by glenoid, acromion, spine, and coracoid fractures, in decreasing order of frequency. 1). Fractures of the scapular body and neck are traditionally treated nonsurgically with good results. Although many classifications are proposed Garden classification and Pauwel classification are generally followed from a practical point of view as these two systems take … 3 2018 Jul. The scapular neck is second only to the body as the most common fracture site, accounting for 26–29% and 35–45% of scapular fractures, respectively [3, 5, 42]; fractures of the spine are less common and account for 6–11% of scapular fractures [3, 5, 42]. 20 to 40% of the fractures are associated with neurological injuries. 1. However, nonoperative management of scapula body fractures showed satisfactory results too. Acta cough may result in an imbalance and/or lack of synergy in Orthop Scand 1999;70:84–5. While such mechanisms have been well described, little is known about scapular body fractures sustained during sporting activities. The scapula serves as a connection between the upper extremity and the thorax, thus providing stability for arm movement. Scapular body fractures are typically treated nonsurgically with good results. A high-force blow to the scapula or thorax can cause a scapular fracture [1], which can occur at various anatomic locations of the scapula such as the spine/body, acromion, neck, and glenoid [2]. Fracture of the mid-shaft of the right third rib. The common reasons for scapular pain are as follows: Injury to the bones – The scapular bones are not prone to injury or fracture. scapular body and spine.15 These fractures generally heal with conservative treatment and do not require operative intervention.3-5,7,9,19 in their systematic review, Zlowodzki et al found that 99% of scapula body fractures were being treated non-operatively with excellent or good results in 86% of cases. occur in association with scapula body, neck, or coracoid fractures that involve the suprascapular notch (Fig. Comparison of 2 versus 3 dimensional fracture mapping strategies for 3 dimensional computerized tomography reconstructions of scapula neck and body fractures. Scapular fractures: Euler and Rüedi classification In: Schulterchirurgie.Edited by Habermeyer P, 261-272 ,1996. fractures of the body of scapula isolated or multifragmentary. Rockwood Classification of Acromioclavicular Joint Separation; Ideberg Classification of Scapular Fractures; 562 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc; 563 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc; … The scapula serves as a connection between the upper extremity and the thorax, thus providing stability for arm movement. Isolated fractures of the coracoid or acromion with minimal displacement (< 1 … 15 The supraspinatus and infraspinatus muscles are … Introduction. Three months after internal fixation of the scapular body fracture, the colt was sound and was turned out to pasture. 4. A scapula fracture is an uncommon injury. Short description: Wedge compression fracture of T11-T12 vertebra, init The 2022 edition of ICD-10-CM S22.080A became effective on October 1, 2021. He says his right upper chest, upper back, and shoulder all hurt. Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. An MRI or CT scan may be used to check for a fracture or other injury. The Acumed Lateral Border Plate provides an innovative plating system for stabilizing scapula body and glenoid neck fractures. Supraglenoid tuberosity avulsion fractures. The study included 14 cases of an isolated body fracture, three of scapular body fracture combined with fracture of the scapular neck and five of glenoid fossa fracture. The neck and scapular body are most commonly involved. Introduction. Scapular body fractures represent less than 1% of all skeletal fractures [6, 12, 24] and generally occur secondary to high-energy, direct trauma to the shoulder sustained during motor vehicle accidents [9, 10, 12].While high-energy mechanisms have been well described for scapular body fractures, little literature exists on scapular body fractures … J to have a displaced scapular body fracture due to Trauma 1980;20:880-.3. strong muscle mantle around it. Fractures of the scapular body. Scapular body fracture. AU - Marra, Guido. The scapula consists of a body, neck and spine portion. Acromion (8% of scapula fractures) Coracoid (7% of scapula fractures) Patients with scapular fractures present with the ipsilateral upper extremity adducted against the body and protected from movement. The authors operated on 22 patients with scapular body fractures, with a mean age of 35 years. We will also attempt to correlate the degree of osseous derangement of a fracture as measured on radiographs with the scores on the 3 respective outcome measures and clinical extremity testing. X-rays of your scapula, collarbone, or arm bones may be checked for broken bones or other problems. This condition is known as “floating shoulder”, because of the inability to control the upper extremity due to mechanical instability resulting from the injury1,2,3. scapula. It is the result of numerous causes, including traumatic, iatrogenic, and idiopathic processes that most often result in nerve injury and paralysis of either the serratus anterior, trapezius, or rhomboid muscles. 2. Structure Image courtesy- Google Images. Diagnosis can be made with plain radiographs. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Major (high-energy) trauma, is the most common cause … Scapular neck, the portion of the bone that connects the glenoid and the scapular body; See Guide to Shoulder Anatomy. Majority of pediatric scapular fractures involve the scapula body. Scapula Fractures are uncommon fractures to the shoulder girdle associated with high energy trauma, associated pulmonary or head injury, and increased injury severity scores. Conclusion. But as seen in this 7. Proper Scapular stabilization exercises can help strengthen your serratus anterior and rhomboid muscles, which in turn will protect your scapula from long term damage. Axial bone window. The scapula is a flat, triangular bone that links the axial skeleton to the upper extremity via only muscular attachments. The scapula plays a critical role in the association between the upper extremity and the axial skeleton. Scapular body stress fracture: a case report. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. A high-force blow to the scapula or thorax can cause a scapular fracture [1], which can occur at various anatomic locations of the scapula such as the spine/body, acromion, neck, and glenoid [2]. Most thoracic spine fractures occur in the lower thoracic spine, with 60% to 70% of thoraco-lumbar fractures occurring in the T11 to L2 region, which is bio-mechanically weak for stress. Conclusion: Classification of scapular body fractures based on involvement of the pillars of the scapular body is logical and simple. Triquetral body fractures appear as clear fracture lines through the body, they are best seen on the oblique projection of the wrist, although cross sectional imaging may be required to further elucidate extent. 25 … Medical professionals distinguish scapula fractures by where they occur in the bone. floating shoulder, scapula, clavicle, glenoid, mechanical instability INTRODUCTION A case of ipsilateral mid-clavicular, scapular body and glenoid fracture is discussed. Scapular dyskinesis-altered scapular positioning and motion-is found in association with most shoulder injuries. reduce the fracture back to the plate in cases where the scapular body fracture is displaced. angle of scapula. We divide them into two basic groups, namely fractures of the … Post-Operative Rehabilitation following ORIF Clavicle Fracture A broken collarbone is also known as a clavicle fracture. 13.6). We will analyze scapular fractures as a group for functional outcomes and compare the outcomes of scapular body against glenoid neck fractures. The scapula and arm are connected to the body by multiple muscle and ligament attachments. Posterior approach to the scapular body and many more surgical approaches described step by step with text and illustrations. Glenoid neck constitute about 25% fractures of the glenoid cavity (glenoid rim and fossa) make up approximately 10% of scapula fractures. How is a scapular fracture diagnosed? Scapula fractures are uncommon in children. Fractures of the scapular body account approximately for 52% of all scapular fractures in both the older and younger groups. Comminuted fracture of the right scapular body. Y1 - 1999/11/30. Scapula fractures account for 1% of all fractures, 3% of shoulder girdle injuries, and 5% of all shoulder fractures. Structure and function. You have sustained a fracture to your scapula (shoulder blade). Acta cough may result in an imbalance and/or lack of synergy in Orthop Scand 1999;70:84–5. There is no significant long-term evaluation on this type of treatment and on the management of scapular malunion. It may increase the functional deficit associated with … The minimal follow-up was 12 months. Glenoid neck fractures: These generally may be treated symptomatically, with early range-of-motion exercises. CT studies are helpful for fracture characterization and for surgical planning. Scapular body fractures: Nonoperative Open reduction may be considered when neurovascular compromise is present and exploration is required. Scapular Fracture: Management. The present … Avulsion fractures can occur due to muscles and ligaments. Ann Rheum Dis 2002;61:944–5. Fracture of the body of the scapula: Etiology: fractures of the scapula generally occur from a direct blow, fall or high-energy trauma. A subset of these fractures, however, respond poorly to nonsurgical treatment, suggesting that some patients may benefit from open reduction and internal fixation (ORIF). reported a scapular body fracture in a professional boxer who sustained the injury during an attempted punch. The location and character of the soft-tissue swelling can also help differentiate a humerus or olecranon fracture from a scapula fracture. [Shannon, 2019] Scapular Neck, Glenoid, and Acromion occur less commonly. Once the fracture begins to heal it is important to keep the shoulder moving; this stops it becoming stiff. This rare, life-threatening injury, is essentially a subcutaneous forequarter amputation. Double disruptions of record superior shoulder suspensory complex. The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest, and arm. The most common scapular fractures are of the body, followed by the neck, glenoid, and acromion. Scapular body fractures • Most common • High incidence of associated injury – look for scapulothoracic dissociation, pneumothorax • Tx – sling for comfort and early motion at 1 – 2 weeks, pulleys at 4 weeks, active motion and progressive strengthening at … More rare causes are seizures, electrical shock treatments, 11, 70, 110, 166 or stress fractures. 1. CONCLUSION: Classification of scapular body fractures based on involvement of the pillars of the scapular body is logical and simple. Scapula neck. CONCLUSION: Classification of scapular body fractures based on involvement of the pillars of the scapular body is logical and simple. Scapular fractures in the pediatric population are rare making up only 1% of all fractures with less than 5% of pediatric fractures occurring at the shoulder [ 5, 13 ]. One year later, the colt was sound and in training to be a flat racehorse. Because of its muscular coverage, scapular fractures are uncommon, representing 3% to 5% of all shoulder girdle injuries and 0.4% to 1% of all fractures.15, 18 Patients are typically an average age of 35 years (range, 25-50 years).1, 14, 21, 24 Fractures of the scapula usually result from major blunt trauma.1, 12, 14, 21, 24 Direct trauma leads to … The differential diagnosis of a clavicle fracture includes acromioclavicular joint injury, rib fracture, scapular fracture, ... Advance activities including muscle endurance activities (upper body ergometer) and cardiovascular endurance exercises (treadmill, cycling) can be prescribed. This is a very common fracture that occurs in people of all ages. The authors concluded a clear advantage of operative treatment in displaced glenoid fractures (3–4 mm) and displaced scapular neck fractures (> 10 mm) with better functional outcomes compared to non-operative management. The fractures of the scapula have an annual incidence of approximately 10/10 5, therefore although the fractures of the scapula body represent between 35-52% of the total, those remain uncommon injuries [1-3].Fractures of the scapular body usually occur in relation to high-energy trauma, and they are commonly associated with local and systemic injuries [2,3]. All patients were treated from the Judet posterior approach. Scapular Fractures in the Pan-scan Era. A 26yo male comes walks into your ED after a 4- wheeler accident. Surgical Treatment. When a scapular body fracture is surgically stabilized, a lateral approach is made over the spine of the scapula. Repair of a scapular body fracture using LCP provided a good outcome with an early return to soundness. The very first classification of scapular fractures, by Jean-Louis Petit 23 identified fractures of the scapula that affected the body, neck and processes; this is a very useful descriptive classification and one therefore sees it at the fundamental level of the much more recent AO/OTA classification. For the scapula, a lateral radiograph of the scapular body can drift of main utility. All fractures were the results of a high impact motor vehicle accident—seven extraarticular body of scapular fracture, and three extraarticular neck of scapular fracture. a transverse two-part fracture associated with a clavicle fracture, accounted for 15% of all scapular body fractures. Scapular body fractures represent less than 1% of all skeletal fractures [6, 12, 24] and generally occur secondary to high-energy, direct trauma to the shoulder sustained during motor vehicle accidents [9, 10, 12].While high-energy mechanisms have been well described for scapular body fractures, little literature exists on scapular body fractures … 1 However, fractures of the scapular neck or glenoid may require surgical intervention. The authors operated on 22 patients with scapular body fractures, with a mean age of 35 years. It is generally easy to feel. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and … Scapular Fracture. A proximal humerus fracture is an injury to the top of the arm bone (the humerus), which forms the ball of the ball-and-socket shoulder joint. In this case because of the fracture pattern the infraspinatus origin was also slightly elevated from the base of the acromial spine exposing the cephalad medial edge of the scapular body fracture. Patients with such fractures should be carefully evaluated because associated injuries are common and may be life threatening. Postoperative 2-year follow-up showed a good result. scapular body and spine.15 These fractures generally heal with conservative treatment and do not require operative intervention.3-5,7,9,19 in their systematic review, Zlowodzki et al found that 99% of scapula body fractures were being treated non-operatively with excellent or good results in 86% of cases. • No supporting of body weight Suggested Therapeutic Exercises • PROM of shoulder: - Flexion to 90 degrees - ER to 30 degrees - IR to tolerance (no behind back) • Scapular clocks: - Elevation, depression, retraction, protraction • Pendulums (Codman’s) • Incision mobilization Other major injuries often accompany scapular fractures, such as fractures in the shoulder, collarbone and ribs, or damage to the head, lungs, or spinal cord. Scapular body fractures generally occur as a result of high-energy, direct trauma to the shoulder sustained in automobile accidents. Subcapital fracture is the most common type of intracapsular neck of femur fracture.The fracture line extends through the junction of the head and neck of femur. Scapula fractures are commonly the result of high-energy injuries [4, 25, 37].Associated injuries are frequent. Surgery for a scapular fracture may be recommended when: The angle of the bone causes a deformity in the limb (angular deformity) 3 The bone positioning is no longer in its correct, anatomical position (displacement) 3 The glenoid socket is fractured, causing instability of the ball and socket joint Always double your elbow against wrong side. Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. This is the American ICD-10-CM version of S22.080A - other international versions of ICD-10 S22.080A may differ. Exam is otherwise normal. J Orthop Res. Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements.It occurs in a large number of injuries involving the shoulder joint and often is caused by injuries that result in the inhibition or disorganization of activation patterns in scapular stabilizing muscles. All patients were treated from the … The fracture of the lateral pillar was displaced in all cases more than that of the spinal pillar. The fracture line always propagated through the weakened central part of the spinal pillar. A literature search found two pediatric cases of intrathoracic displacement of scapular body fracture. BURGER / Getty Images. The fracture of the lateral pillar was displaced in all cases more than that of the spinal pillar. Ice is used for swelling, and pain medications are used for pain control. McLennan JG. Treatment: most scapular fractures respond well to conservative treatment by a physical therapist. Surgical Treatment. After incision of the deep fascia along the spine of the scapula, the omotransversarius and trapezius muscles are retracted cranially, and the spinous head of the deltoideus muscle is retracted caudally. Fractures of the scapular body comprise 50% of all scapular fractures and are often transverse or oblique. The minimal follow-up was 12 months. evaluating traumatic scapular fracture and describe imaging findings associated with operative management indications. This case report presents a missed scapular fracture and associated rib fractures with subsequent malunion and a 23-year follow-up assessment. Pneumothorax compli- case, we can have a grossly displaced body fracture cating fracture of scapula. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. those that are extra-articular. There is a high incidence of associated chest and lung injuries such as rib fractures, pneumothorax, and pulmonary contusion. After incision of the deep fascia along the spine of the scapula, the omotransversarius and trapezius muscles are retracted cranially, and the spinous head of the deltoideus muscle is retracted caudally. Fractures of the scapular body are the type most likely to be accompanied by other injuries, with bony and soft tissue injuries accompany these fractures 80–95% of the time. Most scapular body fractures can be managed conservatively with good healing due to rich blood supply from the surrounding muscles., However, shoulder function may be reduced after conservative treatment of markedly displaced fractures with chronic pain in 12% of patients and radiographic scapular deformity in 25% of patients.

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