Fractures of the scapula

Abstract

Although scapular fractures only occur infrequently, the anatomical location of the scapula means that it is critical for thoracic limb function, therefore appropriate treatment is essential in maintaining limb function. The scapula has a substantial protective soft tissue envelope and considerable trauma is required to fracture it; consequently a high proportion of patients suffer concurrent injuries that may take precedence for management on initial presentation. Scapular fractures are generally classified as stable extra-articular, unstable extra-articular and intra-articular, with surgical treatment being advised for the latter two categories. Cases for which conservative management is appropriate carry an excellent prognosis, as healing generally occurs quickly and shoulder function is often restored even in cases of malunion. Open reduction and internal fixation is employed for some scapular body and spine fractures, fractures of the acromion, most fractures of the scapular neck, fractures of the supraglenoid tuberosity and fractures of the glenoid. The prognosis following scapular body fracture repair is generally excellent, the prognosis for scapular neck fractures is good to excellent, while the prognosis for articular fractures may be poorer, with the majority of dogs regaining function but with a persistent lameness associated. Salvage options are rarely required following scapular fracture, but include shoulder arthrodesis, excision arthroplasty and partial scapulectomy.