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Surgery for scapula process fractures: good outcome in 26 patients.

Anavian J, Wijdicks CA, Schroder LK, Vang S, Cole PA - Acta Orthop (2009)

Bottom Line: Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results.There were no other complications.While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder suspensory complex.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA.

ABSTRACT

Background: Generally, scapula process fractures (coracoid and acromion) have been treated nonoperatively with favorable outcome, with the exception of widely displaced fractures. Very little has been published, however, regarding the operative management of such fractures and the literature that is available involves very few patients. Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results.

Methods: We reviewed 26 consecutive patients (27 fractures) treated between 1998 and 2007. Operative indications for these process fractures included either a painful nonunion, a concomitant ipsilateral operative scapula fracture, > or = 1 cm of displacement on X-ray, or a multiple disruption of the superior shoulder suspensory complex. All patients were followed until they were asymptomatic, displayed radiographic fracture union, and had recovered full motion with no pain.

Patients and results: 21 males and 5 females, mean age 36 (18-67) years, were included in the study. 18 patients had more than one indication for surgery. Of the 27 fractures, there were 13 acromion fractures and 14 coracoid fractures. 1 patient was treated for both a coracoid and an acromion fracture. Fracture patterns for the acromion included 6 acromion base fractures and 7 fractures distal to the base. Coracoid fracture patterns included 11 coracoid base fractures and 3 fractures distal to the base. Mean follow-up was 11 (2-42) months. All fractures united and all patients had recovered full motion with no pain at the time of final follow-up. 3 patients underwent removal of hardware due to irritation from hardware components that were too prominent. There were no other complications.

Interpretation: While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder suspensory complex.

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Related in: MedlinePlus

AP illustration of the scapula showing the 14 coracoid fracture patterns seen in this cohort. The patterns together yield the “coracoid fracture map.”
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Figure 0001: AP illustration of the scapula showing the 14 coracoid fracture patterns seen in this cohort. The patterns together yield the “coracoid fracture map.”

Mentions: Overlay of the fractures yielded illustrations of the coracoid and acromion fracture patterns and demonstrated the morphological variation with which these fracture patterns occurred (Figures 1 and 2). The overlaid fracture patterns followed a reproducible, non-random path. This observation was more apparent for acromion fractures, in that there was a recurring pattern at the base of the acromion.


Surgery for scapula process fractures: good outcome in 26 patients.

Anavian J, Wijdicks CA, Schroder LK, Vang S, Cole PA - Acta Orthop (2009)

AP illustration of the scapula showing the 14 coracoid fracture patterns seen in this cohort. The patterns together yield the “coracoid fracture map.”
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823212&req=5

Figure 0001: AP illustration of the scapula showing the 14 coracoid fracture patterns seen in this cohort. The patterns together yield the “coracoid fracture map.”
Mentions: Overlay of the fractures yielded illustrations of the coracoid and acromion fracture patterns and demonstrated the morphological variation with which these fracture patterns occurred (Figures 1 and 2). The overlaid fracture patterns followed a reproducible, non-random path. This observation was more apparent for acromion fractures, in that there was a recurring pattern at the base of the acromion.

Bottom Line: Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results.There were no other complications.While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder suspensory complex.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA.

ABSTRACT

Background: Generally, scapula process fractures (coracoid and acromion) have been treated nonoperatively with favorable outcome, with the exception of widely displaced fractures. Very little has been published, however, regarding the operative management of such fractures and the literature that is available involves very few patients. Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results.

Methods: We reviewed 26 consecutive patients (27 fractures) treated between 1998 and 2007. Operative indications for these process fractures included either a painful nonunion, a concomitant ipsilateral operative scapula fracture, > or = 1 cm of displacement on X-ray, or a multiple disruption of the superior shoulder suspensory complex. All patients were followed until they were asymptomatic, displayed radiographic fracture union, and had recovered full motion with no pain.

Patients and results: 21 males and 5 females, mean age 36 (18-67) years, were included in the study. 18 patients had more than one indication for surgery. Of the 27 fractures, there were 13 acromion fractures and 14 coracoid fractures. 1 patient was treated for both a coracoid and an acromion fracture. Fracture patterns for the acromion included 6 acromion base fractures and 7 fractures distal to the base. Coracoid fracture patterns included 11 coracoid base fractures and 3 fractures distal to the base. Mean follow-up was 11 (2-42) months. All fractures united and all patients had recovered full motion with no pain at the time of final follow-up. 3 patients underwent removal of hardware due to irritation from hardware components that were too prominent. There were no other complications.

Interpretation: While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder suspensory complex.

Show MeSH
Related in: MedlinePlus