Inferior scapula avulsion fracture: an unusual presentation of winged scapula

Abstract

Inferior scapula avulsion fractures are rare injuries, with few cases reported and only a small number managed operatively discussed in the literature. We report the case of a man in his 40s who fell from a height and presented with right-sided scapular winging and point tenderness at the inferior pole of his right scapula with no neurological deficit. Radiographs and CT diagnosed avulsion fracture of the inferior scapula. The patient underwent surgical fixation and, following a course of physiotherapy, successfully recovered with no residual winging and full range of movement.

Keywords: Orthopaedic and trauma surgery; Orthopaedics.

Figure 1

CT scan images in the coronal (A) and sagittal (B) planes, with arrows demonstrating the inferior pole fracture fragment.

Figure 2

(A) and (B) three-dimensional reconstructed CT scan images demonstrating the scapula, with arrows demonstrating the inferior pole fracture fragment.

Figure 3

Plain radiograph (anteroposterior view) of the right shoulder.

Figure 4

Plain radiograph of the right scapula (oblique view), arrow indicates inferior pole fracture fragment.

Figure 5

Intraoperative photograph of the inferior pole of the scapula fragment being held in forceps prior to repair (arrow indicating fracture fragment).

Figure 6

Intraoperative photograph of suture fixation of the inferior pole of the scapula fragment post repair (arrow indicating suture repair).