Scapula Fractures

Abstract

Fractures of the body of the scapula are usually high-energy injuries resulting from a directly applied force. Fractures of the spine of the scapula and blade are therefore often associated with chest trauma and possibly abdominal and head injury. Fractures of the acromion result from a force applied to the point of the shoulder, and, if downwardly directed, the brachial plexus is vulnerable. High-energy forces directed to the front of the shoulder can tear the acromioclavicular joint apart and, in extreme cases, produce a scapulothoracic dissociation with vascular injury. If the force is transmitted to the scapula through the upper limb, then fractures of the glenoid fossa can occur, with or without glenohumeral dislocation. Of course, any combination of these injuries can occur depending on the energy delivered to the shoulder girdle and its vectors. The surgical management of scapular fractures is most often indicated for displaced injuries including the glenoid fossa. However, the approach differs significantly with fracture location. This chapter is focused on modern reduction and fixation techniques of scapula fractures.