Skip to main content

Advertisement

SpringerLink
Log in

Case Report: Reconstruction of a Recalcitrant Scapular Neck Nonunion and Literature Review

  • Case Report
  • Published:
Clinical Orthopaedics and Related Research

Abstract

We present the first reported treatment failure of a reconstructed scapula body that proceeded to nonunion. This is a unique case report of an otherwise healthy patient who underwent open reduction and internal fixation of a scapula fracture nonunion, which is very rare. Failure of internal fixation in this application has not been reported, and, to our knowledge, this is only the fifth case report of a scapula body nonunion that was reconstructed. Of 159 reported cases of open reduction and internal fixation for treatment of scapula neck and body fractures (with or without intraarticular glenoid fractures), there is not one reported case of a nonunion. Our case is described in detail, including the method of surgical reconstruction, and a review of the literature regarding surgical treatment of scapula nonunions after nonoperative treatment also is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1A–B
Fig. 2A–B
Fig. 3
Fig. 4A–B

References

  1. Ada JR, Miller ME. Scapular fractures: analysis of 113 cases. Clin Orthop Relat Res. 1991;269:174–180.

    PubMed  Google Scholar 

  2. Bauer G, Fleischmann W, Dussler E. Displaced scapular fractures: indication and long-term results of open reduction and internal fixation. Arch Orthop Trauma Surg. 1995;114:215–219.

    Article  PubMed  CAS  Google Scholar 

  3. Boerger TO, Limb D. Suprascapular nerve injury at the spinoglenoid notch after glenoid neck fracture. J Shoulder Elbow Surg. 2000;9:236–237.

    Article  PubMed  CAS  Google Scholar 

  4. Bohm P. Pseudarthrosis of the spine of the scapula: case report of a minimally invasive osteosynthesis technique. Acta Orthop Scand. 1998;69:645–647.

    PubMed  CAS  Google Scholar 

  5. Charlton WP, Kharazzi D, Alpert S, Glousman RE, Chandler RW. Unstable nonunion of the scapula: a case report. J Shoulder Elbow Surg. 2003;12:517–519.

    Article  PubMed  Google Scholar 

  6. Cole PA. Scapula fractures: open reduction internal fixation. In: Wiss D, ed. Master Techniques in Orthopaedic Surgery, Fractures. 2nd Ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:15–36.

    Google Scholar 

  7. Cole PA, Marek DA. Shoulder girdle injuries. In: Stannard JP, Schmidt AH, Kregor PJ, eds. Surgical Treatment of Orthopaedic Trauma. New York, NY: Thieme Medical Publishers, Inc; 2007:207–236.

    Google Scholar 

  8. Darrach W. Fractures of the acromion process of the scapula. Ann Surg. 1914;59:455–456.

    Google Scholar 

  9. Dounchis JS, Pedowitz RA, Garfin SR. Symptomatic pseudarthrosis of the acromion: report of a case and review of the literature. J Orthop Trauma. 1999;13:63–66.

    Article  PubMed  CAS  Google Scholar 

  10. Egol KA, Connor PM, Karunakar MA, Sims SH, Bosse MJ, Kellam JF. The floating shoulder: clinical and functional results. J Bone Joint Surg Am. 2001;83:1188–1194.

    PubMed  Google Scholar 

  11. Ferraz IC, Papadimitriou NG, Sotereanos DG. Scapular body nonunion: a case report. J Shoulder Elbow Surg. 2002;11:98–100.

    Article  PubMed  Google Scholar 

  12. Garcia-Elias M, Salo JM. Non-union of a fractured coracoid process after dislocation of the shoulder: a case report. J Bone Joint Surg Br. 1985;67:722–723.

    PubMed  CAS  Google Scholar 

  13. Gupta R, Sher J, Williams GR Jr, Iannotti JP. Non-union of the scapular body: a case report. J Bone Joint Surg Am. 1998;80:428–430.

    Article  PubMed  CAS  Google Scholar 

  14. Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg Br. 1984;66:725–731.

    PubMed  CAS  Google Scholar 

  15. Herscovici D Jr, Sanders R, DiPasquale T, Gregory P. Injuries of the shoulder girdle. Clin Orthop Relat Res. 1995;318:54–60.

    PubMed  Google Scholar 

  16. Kaminsky SB, Pierce VD. Nonunion of a scapula body fracture in a high school football player. Am J Orthop. 2002;31:456–457.

    PubMed  Google Scholar 

  17. Kavanagh BF, Bradway JK, Cofield RH. Open reduction and internal fixation of displaced intra-articular fractures of the glenoid fossa. J Bone Joint Surg Am. 1993;75:479–484.

    PubMed  CAS  Google Scholar 

  18. Khallaf F, Mikami A, Al-Akkad M. The use of surgery in displaced scapular neck fractures. Med Princ Pract. 2006;15:443–448.

    Article  PubMed  CAS  Google Scholar 

  19. Labler L, Platz A, Weishaupt D, Trentz O. Clinical and functional results after floating shoulder injuries. J Trauma. 2004;57:595–602.

    Article  PubMed  Google Scholar 

  20. Lantry JM, Roberts CS, Giannoudis PV. Operative treatment of scapular fractures: a systematic review. Injury. 2008;39:271–283.

    Article  PubMed  Google Scholar 

  21. Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle. J Bone Joint Surg Am. 1993;75:1015–1018.

    PubMed  CAS  Google Scholar 

  22. Mayo KA, Benirschke SK, Mast JW. Displaced fractures of the glenoid fossa: results of open reduction and internal fixation. Clin Orthop Relat Res. 1998;347:122–130.

    Article  PubMed  Google Scholar 

  23. McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980;20:880–883.

    Article  PubMed  CAS  Google Scholar 

  24. McGinnis M, Denton JR. Fractures of the scapula: a retrospective study of 40 fractured scapulae. J Trauma. 1989;29:1488–1493.

    Article  PubMed  CAS  Google Scholar 

  25. Michael D, Fazal MA, Cohen B. Nonunion of a fracture of the body of the scapula: case report and literature review. J Shoulder Elbow Surg. 2001;10:385–386.

    Article  PubMed  CAS  Google Scholar 

  26. Mick CA, Weiland AJ. Pseudarthrosis of a fracture of the acromion. J Trauma. 1983;23:248–249.

    Article  PubMed  CAS  Google Scholar 

  27. Naested J, Jorgensen U, Torholm C. Pseudoarthrosis of the acromion: a differential diagnosis in anterolateral shoulder pain. Scand J Med Sci Sports. 1995;5:105–106.

    Article  PubMed  CAS  Google Scholar 

  28. Newell ED. Review of over two thousand fractures in past seven years. South Med J. 1927;20:644–648.

    Google Scholar 

  29. Ogawa K, Naniwa T. Fractures of the acromion and the lateral scapular spine. J Shoulder Elbow Surg. 1997;6:544–548.

    Article  PubMed  CAS  Google Scholar 

  30. Oh W, Jeon IH, Kyung S, Park C, Kim T, Ihn C. The treatment of double disruption of the superior shoulder suspensory complex. Int Orthop. 2002;26:145–149.

    Article  PubMed  Google Scholar 

  31. Robinson CM, Court-Brown CM. Non-union of scapula spine fracture treated by bone graft and plate fixation. Injury. 1993;24:428–429.

    Article  PubMed  CAS  Google Scholar 

  32. Rowe CR. Fractures of the scapula. Surg Clin North Am. 1963;43:1565–1571.

    PubMed  CAS  Google Scholar 

  33. Schandelmaier P, Blauth M, Schneider C, Krettek C. Fractures of the glenoid treated by operation: a 5- to 23-year follow-up of 22 cases. J Bone Joint Surg Br. 2002;84:173–177.

    Article  PubMed  CAS  Google Scholar 

  34. Schwartzbach CC, Seoudi H, Ross AE, Hendershot K, Robinson L, Malekzadeh A. Fracture of the scapula with intrathoracic penetration in a skeletally mature patient: a case report. J Bone Joint Surg Am. 2006;88:2735–2738.

    Article  PubMed  Google Scholar 

  35. Wilber MC, Evans EB. Fractures of the scapula: an analysis of forty cases and a review of the literature. J Bone Joint Surg Am. 1977;59:358–362.

    PubMed  CAS  Google Scholar 

  36. Wilson PD. Experience of the Management of Fractures and Dislocations (Based on Analysis of 4,390 Cases) by Staff of the Fracture Service MGH, Boston. Philadelphia, PA: JB Lippincott; 1938.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA

    Daniel J. Marek MD, Marc F. Swiontkowski MD & Peter A. Cole MD

  2. Department of Orthopaedic Surgery, Naval Medical Center, San Diego, CA, USA

    V. Franklin Sechriest II MD

  3. Department of Orthopaedic Surgery, Regions Hospital, 640 Jackson Street, St Paul, MN, 55101, USA

    Peter A. Cole MD

Authors
  1. Daniel J. Marek MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Franklin Sechriest II MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marc F. Swiontkowski MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter A. Cole MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter A. Cole MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

About this article

Cite this article

Marek, D.J., Sechriest, V.F., Swiontkowski, M.F. et al. Case Report: Reconstruction of a Recalcitrant Scapular Neck Nonunion and Literature Review. Clin Orthop Relat Res 467, 1370–1376 (2009). https://doi.org/10.1007/s11999-008-0651-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-008-0651-3

Keywords

Search

Navigation