Case report of an unusual extra-articular scapular malunion: Rare indication for surgery. (October 2021)

• Record Type: Journal Article
• Authors: Mishra, Bhanu; Grocott, N; Smith, K; McClelland, D
• Is Part Of: Shoulder & elbow. Volume 13:Number 5(2021)
• Page Start: 534
• Page End: 537
• Publication Date: 2021-10
• Subjects: Impingement -- malunion -- scapula; Elbow -- Diseases -- Periodicals; Elbow -- Surgery -- Periodicals; Shoulder -- Diseases -- Periodicals; Shoulder -- Surgery -- Periodicals; Shoulder -- Periodicals; Elbow -- Periodicals; Shoulder Joint -- Periodicals; Elbow Joint -- Periodicals; 617.572005
• DOI: 10.1177/1758573220906557
• Languages: English
• ISSNs: 1758-5732

Abstract

Introduction: Scapular fractures are relatively rare injuries usually associated with high-energy trauma and multiple concomitant injuries. Most of scapular fractures do not require surgical intervention. Patient and clinical history: A 42-year-old male sustained an extra-articular scapular body fracture along with multiple rib fractures with flail segments and right pneumothorax treated with intercostal drain. The scapula fracture was treated non-operatively initially, which resulted in very poor outcome. Operative intervention was planned following scans which showed a bony spike from the ventral surface impinging on the chest wall. Surgical technique: Bony spur was approached from dorsal side using a three-dimensional anatomical model as a guide for accurate localization. Results: The patient's symptoms including shoulder stiffness and pain on deep inspiration settled down completely following removal of the spur. Discussion: This case presents a new indication for surgical intervention in scapular body fracture which has not been published before. All the relevant measurements related to the fracture namely gleno-polar angle, lateral border offset and angulation were within published limits of indications for conservative treatment. Despite this, it resulted in poor outcome necessitating surgical intervention.