Operative treatment of complex intra-articular scapular fractures: long-term functional outcomes in a single-center study

Abstract

Background: Scapula fractures occur in the setting of high-energy trauma. Operative treatment of complex intra-articular scapular fractures can result in adequate surgical and functional outcomes.

Materials and methods: Twenty-seven patients with complex, displaced intra-articular scapular fractures with or without involvement of the scapular body, were treated operatively in a single trauma center between 2010 and 2021. Associated injuries such as ipsilateral upper limb fractures and nerve injuries were identified in the majority of the patients. Fixation with anatomical medial and lateral border precontoured plates was utilized following posterior modified Judet approach or/and anterior deltopectoral approach. Functional outcome was assessed using the Oxford Shoulder Score and detailed shoulder range of motion and return to work/activities data were obtained.

Results: At a mean follow-up of 69 months (range 4-135 months), individual functional outcomes for 25 of the 27 patients revealed a mean Oxford Shoulder Score of 33 (69%), mean active flexion of 120 degrees, active abduction of 110 degrees, mean active external rotation of 35 degrees and mean internal rotation to the level of T5. All patients were pain-free at the latest follow-up, and 23 of 25 had returned to their preinjury occupation and activities.

Conclusion: Operative treatment for these complex injuries is a viable option at centers equipped to handle critically ill patients and can result in satisfactory range of motion and functional score measurements along with a relatively low number of complications.

Keywords: Intra-articular; Operative outcomes; Scapula fracture.