Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 5, pp 669–673 | Cite as

A Reverse Judet approach to the scapula

  • Manohara Ruben 
  • V. Prem Kumar
Trauma Surgery


Fractures of the scapular body that extend to involve the neck and glenoid articular surface with a large gap pose a significant problem for surgical exposure. Several surgical approaches for scapula fixation have been described, but all give limited exposure to the entire scapular body, neck and articular surface. Here, we describe our ‘Reverse Judet’ technique, with cadaveric dissections and discuss a clinical case. We believe this approach gives a wide exposure of the infraspinous scapular body, neck and glenoid articular surface while keeping away from vital neural structures.


Scapula Fracture Fixation Surgical approach Judet 



There is no funding source. The authors did not receive any outside funding or grants in support of their research or preparation of this work. Neither they nor any member of their immediate families received payments or other benefits, or a commitment or agreement to provide such benefits from a commercial entity. This paper was not presented at any meeting and no funding was received for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. For this type of retrospective study formal consent is not required.


  1. 1.
    Nordqvist A, Petersson C (1992) Fracture of the body, neck, or spine of the scapula. A long-term follow-up study. Clin Orthop Relat Res 283:139–144Google Scholar
  2. 2.
    Edwards SG, Whittle AP, Wood GW 2nd (2000) Nonoperative treatment of ipsilateral fractures of the scapula and clavicle. J Bone Joint Surg Am 82:774–780CrossRefPubMedGoogle Scholar
  3. 3.
    Scavenius M, Stoth C (1996) Fractures of the scapula. Acta Orthop Belg 62:129–132PubMedGoogle Scholar
  4. 4.
    Hardegger FH, Simpson LA, Weber BG (1984) The operative treatment of scapular fractures. J Bone Jt Surg Br 66:725–731CrossRefGoogle Scholar
  5. 5.
    Bestard EA, Schvene HR, Bestard EH (1986) Glenoplasty in the management of recurrent shoulder dislocation. Contemp Orthop 12:47–55Google Scholar
  6. 6.
    Goss TP (1995) Scapular fractures and dislocations: diagnosis and treatment. J Am Acad Orthop Surg 3:22–33CrossRefPubMedGoogle Scholar
  7. 7.
    Bartonícek J, Tucek M, Lunácek L (2008) Judet posterior approach to the scapula. Acta Chir Orthop Traumatol Cech 75:429–435PubMedGoogle Scholar
  8. 8.
    Obremskey WT, Lyman JR (2004) A modified Judet approach to the scapula. J Orthop Trauma 18:696–699CrossRefPubMedGoogle Scholar
  9. 9.
    Norwood LA, Matiko JA, Terry GC (1985) Posterior shoulder approach. Clin Orthop Relat Res 201:167–172Google Scholar
  10. 10.
    Pizanis A, Tosounidis G, Braun C, Pohlemann T, Wirbel RJ (2013) The posterior two-portal approach for reconstruction of scapula fractures: results of 39 patients. Injury 44:1630–1635CrossRefPubMedGoogle Scholar
  11. 11.
    Gauger EM, Cole PA (2011) Surgical technique: a minimally invasive approach to scapula neck and body fractures. Clin Orthop Relat Res 469:3390–3399CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Leechavengvongs S, Teerawutthichaikit T, Witoonchart K, Uerpairojkit C, Malungpaishrope K, Suppauksorn S, Chareonwat B (2015) Surgical anatomy of the axillary nerve branches to the deltoid muscle. Clin Anat 28(1):118–122CrossRefPubMedGoogle Scholar
  13. 13.
    Wirth MA, Butters KP, Rockwood CA Jr (1993) The posterior deltoid-splitting approach to the shoulder. Clin Orthop Relat Res 296:92–98Google Scholar
  14. 14.
    Jerosch J, Greig M, Peuker ET, Filler TJ (2001) The posterior subdeltoid approach: a modified access to the posterior glenohumeral joint. J Shoulder Elbow Surg 10:265–268CrossRefPubMedGoogle Scholar
  15. 15.
    Shaffer BS, Conway J, Jobe FW, Kvitne RS, Tibone JE (1994) Infraspinatus muscle-splitting incision in posterior shoulder surgery. An anatomic and electromyographic study. Am J Sports Med 22:113–120CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNational University of Singapore, National University Health SystemSingaporeSingapore

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