Type 4: horizontal fracture involving both scapula neck and body. Trouble moving your shoulder and arm. The . However, fractures of the scapular body or glenoid neck account for approximately 66-98% of scapula fractures making them the most common fracture pattern ().Scapula fractures are usually the result of high-energy mechanisms and patients frequently have associated injuries. A scapular fracture is rare in athletes, but one with potentially serious implications. Signs: acute onset, forelimb lameness is the most common presentation. It always requires a 3D CT reconstruction, including subtraction of the surrounding bones. Management Historically, scapula fractures have been treated with closed means.
Weak, numb, and tingly shoulder and arm.
Published 1 March 2012.
As the name suggests a Scapula fracture is a fracture of the scapula or the shoulder blade.Normally, the scapula is pretty well protected by a web of muscles and it is very rare that the scapula sustains a fracture, but if there is a Scapula Fracture then it gives an indication that the shoulder must have been injured with a significant amount of force coupled with significant trauma to the chest. Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Conclusion: Classification of scapular body fractures based on involvement of the pillars of the scapular body is logical and simple. doi: 10.1097/BOT.0000000000000159. One of the earliest descriptions of treating scapula fractures was published . Requires trauma series views to demonstrate the fractures due to the superimposition of the shoulder girdle and thoracic cage. The system of scapula fracture classification is based on the mechanism and site of injury (see figure 2 and table 1) (4). Pain, tenderness, swelling, bruising, or a bump in the injured area. The distal fragment had a complete, displaced, longitudinal, articular fracture that divided the distal fragment into cranial and caudal fragments. Chest injuries-ribs #-most common. Acta Orthopaedica . While being present in only a small share of patients with shoulder trauma, numerous classification systems have been in use over the years for categorization of scapula fractures. The following studies are warranted: Complete blood count (CBC) Electrolytes. Bones and Joints. Urinalysis. Navigation menu. This Paper.
The Hardegger classification is similar but names two types of glenoid and two types of neck fractures.
Type 2: inferior glenoid fracture involving part of the neck. Musculoskeletal. Laterally is the glenoid fossa, anteriorly is the coracoid process and superiorly is the . S. Grevsten, S. Larsson: Epidemiology of scapular fractures: incidence and classification of 338 fractures. (Seventy-eight percent of scapula fractures were treated using a posterior approach, 18% had an anterior approach and 4% a combined approach.
OTA Scapula fracture Classification System. 7. Read Paper. Direct impact may cause fractures in all scapular regions, but an indirect trauma caused by the humeral head into the glenoid fossa also may cause intra- and extra-articular scapular fractures [1-4].Although radiographs are essential for diagnosis, including anteroposterior, lateral, and axillary views, computed tomography (CT) plays a critical role in the preoperative planning .
They typically occur as a result of blunt trauma, usually a road traffic accident, fall, possibly a dog bite. A scapular fracture is a fracture of the scapula, the shoulder blade. Several scapular fracture classification systems have been described. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. proposed a classification for acromion fractures after RSA after retrospectively reviewing 400 patients, 22 of which sustained acromion or scapular spine fractures.Type I fractures are small anterior fractures at the level of the acromioclavicular (AC) joint and were hypothesized to be secondary to deltoid avulsion from a weakened acromion. Scapular fractures are commonly described according to the anatomic location (Fig. Broad classification system for scapula fractures that focuses on glenoid involvement but also includes scapular body fractures as well as fractures of the scapular processes.
2 Around 85% occur in people older than 50, and the incidence peaks in the 60- to 90-year-old age-group with a female to male ratio of 70:30. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. Andrew Hamilton explains how it can occur, .
2008. pp. DeCloux MP, Lemerle, Omoplate. Scapula Fractures are uncommon fractures to the shoulder girdle caused by high energy trauma and associated with pulmonary injury, head injury, and increased injury severity scores. Scapula ORIF using Modified Judet Approach by Roger C. Sohn, MD I highly recommend the excellent technique article by Jones, et al in 2009 JOT "Modified Judet Approach and Minifragment Fixation of Scapular Body and Glenoid Neck Fractures". [Method]From May 2000 to November 2007,14 patients(10 females,4 males;mean age 34.6 years . Anterior. Medicine. The fracture of the lateral pillar was displaced in all cases more than that of the spinal pillar. What are the signs and symptoms of a scapular fracture? Acromion fractures may occur as a result of shoulder trauma and overuse injuries. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Scapula Fracture.
Classification Type I: Fracture of the body (49-89%) Type II: Fracture of the apophysis including the coracoid and acromion Type III: Fracture of the supero-lateral angle including the neck/glenoid Explanation Provide an explanation for key principles and 39.
The surgery of the shoulder. Scapula Fractures: Classification, Diagnosis and Radiographic Measur 06:24. Diagnosis. Most fractures of the scapula can be treated without surgery. Full PDF Package Download Full PDF Package. Percutaneous pinning usually is. Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved . [8] Scapular fractures preferentially occur in young males (M: F = 6:49) between the ages of 25 and 50 years old and most often occur in the body or the glenoid. . Acromion fractures constitute 8%-16% of scapula fractures 1).
Swelling or abnormal contour in the region of .
However, there are no restrictions on shoulder motion . The present review article was designed to . body, glenoid, acromion, coracoid) The majority of fractures are treated non-operatively.
Scapular neck fractures occur in about 25% of cases, . Scapular neck fractures are caused by high-energy impact transmitted by an external object or the humeral head [1,5] and account for approximately 5-8% of all scapular fractures [6, 7]. The posterior approach for fixing scapular fractures has advantages of wide exposure, safety, easy operation, and reliable effect and is a choice of operation for most types of scapULAR fractures. Scapular fractures account for approximately 0.4-1% of all fractures, [3] 3% of all fractures of the shoulder, and 5% of all fractures of the shoulder girdle. Scapula fractures are uncommon in children.
The classification of fractures of the scapula (type A: body and process fractures; type B: neck fractures; type C: glenoid fractures) is shown, and the indications for conservative and operative treatment are described, as are the surgical approaches and operative techniques. Treatment algorithm. Top.
CT. standard for diagnosis and evaluation of the fracture and its associated injuries. They include fractures of the superior angle and the upper border of the scapula, fractures of and in the acromion and the scapular spine, and coracoid fractures. Download Download PDF. axillary view. The Ada-Miller fracture classification includes Type I fractures, which consist of acromion (IA), spine (IB), and coracoid (IC) fractures.Type II fractures consists of scapular neck fractures, which are divided into fractures that originate at the neck, run lateral to the spinoglenoid notch, and extend to the suprascapular notch (IIA); fractures that originate at the neck and extend superiorly . Figure 1: Regions of the scapula .
Design: Web-based reliability study. This typically occurs in high energy trauma such as a motor vehicle . 5. [Objective]To investigate the effect of surgical treatment of scapular fractures through posterior approach. Treatment is usually nonoperative with . Body: 45%. 2014 Aug;28(8):e208. Injury. Radiographic series includes: true anterior-posterior view of the scapula. Prothrombin time (PT)/activated partial thromboplastin time . Recently, acromion fractures are seen at the rate of 5%-6.9% as the complication of reverse shoulder arthroplasty 2). Scapular fractures are uncommon, accounting for only 3-5% of shoulder girdle fractures and fewer than 1% of all fractures [].High-energy trauma is the most common cause, and scapular fractures are frequently associated with other acute injuries, including rib fracture (53%), lung injury (47%), head injury (39%), spinal fracture (29%), and clavicle fracture (25%) [].
One of the earliest descriptions of treating scapula fractures was published in 1805 in Desault's treatise on fractures. Posteriorly, the scapula is divided into a supraspinous fossa and infraspinous fossa by the scapular spine. The . Injuries of twenty patients of our study group (18.7%) were classified as Type B injuries. Scapula. summary. Rockwood Classification of Acromioclavicular Joint Separation; Ideberg Classification of Scapular Fractures; Neer Classification of Humeral Head Fractures; AO/OTA Classification of Distal Humeral Fractures; Classifications of Coronoid Process Fractures; Mason-Johnston Classification of Radial Head Fractures; Bado Classification of Monteggia . Type 1A with a fracture fragment of 5 mm or less, and type 1 B with a fracture fragment larger than 5 mm. Type: Scapula, glenoid fossa, multifragmentary (three or more fracture lines) 14F2. Scapula Fractures are uncommon fractures to the shoulder girdle caused by high energy trauma and associated with pulmonary injury, head injury, and increased injury severity scores. The need to support your arm with your other hand to decrease pain. vol. The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles. 8-54% Neurovasclar injuries- brachial plexus 5-13% Head injuries.20% Splenic and liver lacerations 3-5%.
Proximal humerus fractures account for 6% of all fractures in the Western world. Classification of Fractures - Ideberg II Type II: Transverse or oblique fracture through glenoid fossa, exiting inferiorly. Scapular fractures: DeCloux and Lemerle classification. Classification. Scapula fractures account for approximately 1% of all fractures. Open subtypes (2) Transverse. Fractures of the scapula are rare and usually associated with high-energy trauma. Anteriorly, on the costal surface, is the shallow subscapular fossa. Cause: fractures of the canine scapula are uncommon, estimated to account for 0.5-2.4% of all fractures.
Download Download PDF. Type Description Ia Anterior rim fracture Ib Posterior rim fracture II Fracture through glenoid exiting scapula laterally III Fracture through glenoid exiting scapula superiorly IV Fracture through glenoid exiting scapula . Scapula Fracture; . Glenoid fractures are rare 1 and relatively little is known about their mechanism, fracture pattern and optimal treatment strategies. 13 Systems that describe fractures solely on the . Type 3: superior glenoid fracture extending through the base of the coracoid process. Type 1: Scapula body fractures. Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning. fracture (what) at the level of the distal end of the spine of the scapula (where) that separated the scapula into a large proxi-mal fragment and a smaller distal fragment (significance). Clinical and radiological examination; Complete LSSS failure, Floating shoulder, Ligament repair 3; References, Classification 2; Glenoid fossa, extraarticular. P. Cole, Erich M. Gauger, L. Schroder. [10] described an interesting classification system for fractures of scapula body based on the findings of 187 CT scans of patients presenting fractures in this location. Scapula fractures are rare injuries, comprising only about 0.5% of all fractures. Fractures of scapular processes account for 11% of all scapular fractures in our group and for 15% of those in patients over 60 years of age ( Table 18.3 ). The scapula is described as having superior, medial, and lateral borders.
271-83. Type 2: Apophyseal fractures ( coracoid, acromion) Type 3: fractures through the supero- lateral angle of scapula.
Trauma. 10.1 . Bones poking through your skin, or bones not looking normal. Classification of Fractures - Ideberg I Type I: Avulsion fracture of anterior glenoid margin Ideberg R. Fractures of the scapula involving the glenoid fossa. 2,3 More classical fractures of the glenoid can be extra . Patient evaluation. Patrick Szukics . Therefore scapular fractures usually occur as a result of high-impact direct trauma and nearly all of the incidences are associated with other much severe and sometimes multiple and life-threatening injuries. link. More severe then scapula fracture which may delay diagnosis and treatment . Scapulothoracic Joint Classification will sometimes glitch and take you a long time to try different solutions.
Introduction. Journal of the American Academy of Orthopaedic Surgeons. 8.2 Acromial Fracture Classification; 8.3 Ideberg Classification of Glenoid Fracture; 9 Management.
Together, the scapula, humerus, and thorax allow for upper extremity range of motion. 37 Full PDFs related to this paper. Risk of infection . .
Hardegger et al reported that if significant displacement occurs, conservative treatment alone . Management of Scapular Fractures. These include elevation, depression, protraction . [3] [4] Scapular fracture represents less than 1% in prevalence among all other broken bones and 3% to 5% of all shoulder girdle fractures. A new International Scapula Classification system has been proposed and is based on a clinically relevant fracture . The classification of non-displaced, stable Type A complex scapular injuries is summarized in Figure 1.Displaced fractures of the scapula with a stable shoulder girdle thus not representing a floating shoulder were categorized as Type B injuries. They are classified according to the portion of bone involved (i.e.
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