Journal of Orthopaedic Trauma, 2014. Laterally is the glenoid fossa, anteriorly is the coracoid process and superiorly is the .
9.1 Nonoperative; 9.2 Operative; 10 Rehab and Return to Play. The need to support your arm with your other hand to decrease pain. Management of Scapular Fractures. 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". Diagnosis can be made with the edge of the scapula being displaced > 1 cm from the spinous process as compared to the contralateral side. When it does, it is an indication that the individual was subjected to a considerable amount of force and that severe chest trauma may be present. 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. Design: Web-based reliability study. Requires trauma series views to demonstrate the fractures due to the superimposition of the shoulder girdle and thoracic cage. Educational video describing fracture classifications of the scapula.Acromial fractures Kuhn classificationType Ia minimal displacement (avulsion fracture) . 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%) []. 8. Swelling or abnormal contour in the region of . [1] High-speed vehicle accidents are the most common . Scapula Fracture; . The surgery of the shoulder. This typically occurs in high energy trauma such as a motor vehicle . 2014 Aug;28(8):e208. Bartonek et al. Injuries of twenty patients of our study group (18.7%) were classified as Type B injuries. 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 . 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. 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. Scapular body fractures are most commonly encountered, accounting for 50 to 60% of scapular fractures in most series. 80% to 95% of all scapular fractures are . Scapulothoracic Joint Classification will sometimes glitch and take you a long time to try different solutions. Trauma. A short summary of this paper. Type 4: horizontal fracture involving both scapula neck and body. 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 . Scapulothoracic Dissociation is a high-energy traumatic disruption of the scapulothoracic articulation often associated with severe neurovascular injuries, scapula fractures, and clavicular fractures. Injury. The AO/OTA classification of scapula fractures has not gained widespread acceptance in the literature despite its usefulness in long bone fractures. Laboratory evaluation for a patient with a scapula fracture that results from a high-energy mechanism generally is the same as that for a trauma patient. What are the signs and symptoms of a scapular fracture? 7. 2,3 More classical fractures of the glenoid can be extra . summary. Bones poking through your skin, or bones not looking normal. Percutaneous pinning usually is. It always requires a 3D CT reconstruction, including subtraction of the surrounding bones. . Introduction. Download Download PDF. Navigation menu. Posteriorly, the scapula is divided into a supraspinous fossa and infraspinous fossa by the scapular spine. This Paper. Most fractures of the scapula can be treated without surgery. Acromion fractures constitute 8%-16% of scapula fractures 1). Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Scapula Fracture. 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. 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. Scapula Fractures. However, there are no restrictions on shoulder motion . S. Grevsten, S. Larsson: Epidemiology of scapular fractures: incidence and classification of 338 fractures. A new International Scapula Classification system has been proposed and is based on a clinically relevant fracture . Qualificationsare optional and applied to the fracture code where the asterisk is located as a lower-case letter within rounded brackets. Together, the scapula, humerus, and thorax allow for upper extremity range of motion. Scapular fractures: DeCloux and Lemerle classification. 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. Type 2: Apophyseal fractures ( coracoid, acromion) Type 3: fractures through the supero- lateral angle of scapula. They are classified according to the portion of bone involved (i.e. &NA; With the exception of displaced articular glenoid fractures, management of scapular fractures has largely consisted of benign neglect, with an emphasis on motion as allowed by . [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. Anteriorly, on the costal surface, is the shallow subscapular fossa. Antonio Barquet. High-energy, blunt trauma injuries, such as those experienced in a motorcycle or motor vehicle collision or falling . Download Download PDF. 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 involves immobilization with a sling or a shoulder immobilizer, icing and pain medications.
37 Full PDFs related to this paper. Blood urea nitrogen (BUN)/creatinine. 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. Glenoid fractures are rare 1 and relatively little is known about their mechanism, fracture pattern and optimal treatment strategies. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery. Scapula fractures are uncommon in children. Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved . 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. Classification of Fractures - Ideberg II Type II: Transverse or oblique fracture through glenoid fossa, exiting inferiorly. In our hospital, 93 patients with 153 fractures of the scapula type . 11-11). Urinalysis. doi: 10.1097/BOT.0000000000000159. Published 1 March 2012. The . Another limitation is a lack of correlation with a clinical series of fractures. 5. Scapula fractures account for approximately 1% of all fractures. 271-83.
10.1 . Lille Chir: 215-227, 1956. Fractures that involve the glenoid fossa may occur as a result of dislocation and, when present, bony avulsions and rim fractures are strongly associated with anterior shoulder dislocations. Clinical and radiological examination; Complete LSSS failure, Floating shoulder, Ligament repair 3; References, Classification 2; Glenoid fossa, extraarticular. 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1 Following the distal radius and vertebra, it is the third most common osteoporotic fracture. Pain, tenderness, swelling, bruising, or a bump in the injured area. [Objective]To investigate the effect of surgical treatment of scapular fractures through posterior approach. Open subtypes (2) Posterior. There is a high incidence of associated chest and lung injuries such as rib fractures, pneumothorax, and pulmonary contusion. 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 1: Scapula body fractures. The distal fragment had a complete, displaced, longitudinal, articular fracture that divided the distal fragment into cranial and caudal fragments. Conclusion: Classification of scapular body fractures based on involvement of the pillars of the scapular body is logical and simple. Read Paper. Historically, these fractures have been treated by closed means. Mortality due to associated injuries- 2-15%. 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. When contemplating operative vs. nonoperative treatment, surgeons should consider patient age, activity level, scapula fracture severity . Scapular neck fractures occur in about 25% of cases, . Several scapular fracture classification systems have been described. CT. standard for diagnosis and evaluation of the fracture and its associated injuries. Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning. body, glenoid, acromion, coracoid) The majority of fractures are treated non-operatively. The Ideberg classification is a system of categorizing scapula fractures involving the glenoid fossa. Full PDF Package Download Full PDF Package. Acta Orthopaedica . Crosby et al. . Acromion fractures may occur as a result of shoulder trauma and overuse injuries. Scapula Fractures: Classification, Diagnosis and Radiographic Measur 06:24. A scapular fracture is a fracture of the scapula, the shoulder blade. Treatment is usually nonoperative with . Prothrombin time (PT)/activated partial thromboplastin time . Open subtypes (2) Transverse. Bones and Joints. The Hardegger classification is similar but names two types of glenoid and two types of neck fractures. Top.
The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles. The scapula is described as having superior, medial, and lateral borders. Medicine. A scapular fracture is rare in athletes, but one with potentially serious implications. Radiographic series includes: true anterior-posterior view of the scapula. [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. Chest injuries-ribs #-most common. Scapula Fracture (Shoulder Blade Fracture): Scapular fracture is the fracture of scapula which is rare and is often caused by direct trauma from the back or side. Scapula. . Scapula fractures are rare injuries, comprising only about 0.5% of all fractures. Furthermore, the literature is controversial regarding surgical indications and rationale for treatment. Cause: fractures of the canine scapula are uncommon, estimated to account for 0.5-2.4% of all fractures. Scapular fractures are commonly described according to the anatomic location (Fig. Trouble moving your shoulder and arm. Fractures of the scapula are rare and usually associated with high-energy trauma.
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]. Download Full PDF Package. Open subtypes (2) Type: Scapula, glenoid fossa, multifragmentary (three or more fracture lines) 14F2. 1(p. 691-697) A 2006 Finnish. lateral view. 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. Recently, acromion fractures are seen at the rate of 5%-6.9% as the complication of reverse shoulder arthroplasty 2). Shoulder and Humerus. The scapula is a triangular-shaped bone that articulates with the clavicle at the acromioclavicular joint, with the humerus at the glenohumeral joint, and with the thorax at the scapulothoracic joint. Glenoid fossa, partial articular. Type 2: inferior glenoid fracture involving part of the neck. Treatment algorithm.
A Scapula Fracture, or shoulder blade fracture, refers to a break of the scapula. Introduction. Journal of the American Academy of Orthopaedic Surgeons. LoginAsk is here to help you access Scapulothoracic Joint Classification quickly and handle each specific case you encounter. The purpose of this study was to evaluate the established AO/OTA classification in comparison to the . The present review article was designed to . Patient evaluation. Classification of Fractures - Ideberg I Type I: Avulsion fracture of anterior glenoid margin Ideberg R. Fractures of the scapula involving the glenoid fossa. The . Figure 1: Regions of the scapula . Type 3: superior glenoid fracture extending through the base of the coracoid process. This classification is based on the experience of 37 operatively treated fractures. Bookmarks. 14F. The fracture of the lateral pillar was displaced in all cases more than that of the spinal pillar. [3] [4] Scapular fracture represents less than 1% in prevalence among all other broken bones and 3% to 5% of all shoulder girdle fractures. P. Cole, Erich M. Gauger, L. Schroder. Musculoskeletal. 2008. pp. Andrew Hamilton explains how it can occur, . One of the earliest descriptions of treating scapula fractures was published in 1805 in Desault's treatise on fractures. (Seventy-eight percent of scapula fractures were treated using a posterior approach, 18% had an anterior approach and 4% a combined approach. Acromion fractures may occur with glenoid process, scapula or clavicle distal . The scapula is sturdy and located in a protected place, so it rarely breaks. Diagnosis. They typically occur as a result of blunt trauma, usually a road traffic accident, fall, possibly a dog bite.
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. Scapula Fractures: Interobservor Reliability of Classification and Treatment J Orthop Trauma. Hardegger et al reported that if significant displacement occurs, conservative treatment alone . More than one qualification can be applied for a given fracture classification, separated by a comma. Type 1A with a fracture fragment of 5 mm or less, and type 1 B with a fracture fragment larger than 5 mm. 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. 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%) []. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulder's range of motion. 13 Systems that describe fractures solely on the . Risk of infection . Patrick Szukics . Anterior. Classification. 6. More severe then scapula fracture which may delay diagnosis and treatment . Body: 45%. DeCloux MP, Lemerle, Omoplate. 306 is a non-billable ICD-10 code for Unspecified fracture of fifth metacarpal bone, right hand 31700002 1500 Related online courses on Physioplus In both instances, the CPT was administered following 10 min supine rest CPT Code Description Internal Fixation (cont CPT Code Description Internal Fixation (cont. link. OTA Scapula fracture Classification System. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. One of the earliest descriptions of treating scapula fractures was published . . Signs: acute onset, forelimb lameness is the most common presentation. Management Historically, scapula fractures have been treated with closed means. The following studies are warranted: Complete blood count (CBC) Electrolytes. Background. vol. 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 ). 8-54% Neurovasclar injuries- brachial plexus 5-13% Head injuries.20% Splenic and liver lacerations 3-5%. These include elevation, depression, protraction . Morphology and glenoid involvement determine the necessity of surgical management in scapula fractures. 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). 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. The system of scapula fracture classification is based on the mechanism and site of injury (see figure 2 and table 1) (4). Proximal humerus fractures account for 6% of all fractures in the Western world. Classification. Weak, numb, and tingly shoulder and arm. [Method]From May 2000 to November 2007,14 patients(10 females,4 males;mean age 34.6 years . 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 8.2 Acromial Fracture Classification; 8.3 Ideberg Classification of Glenoid Fracture; 9 Management. 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 . 39. 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. Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning.
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