Abstract
BackgroundThis study aimed to compare the functional outcomes of the Y-type locking plate with the straight reconstruction locking plate for severe displaced scapular fractures.MethodsThis was a retrospective cohort study of 37 patients with severe displaced scapular body and neck fractures treated between July 2013 and October 2016 at the Hanzhong Central Hospital. Treatment selection was based on the surgeon’s experience and discussion with the patient. Sixteen patients received Y-type locking plates and 21 patients received straight reconstruction locking plates. The primary indexes were the Constant Shoulder Function (CSF) and Disabilities of the arm, shoulder, and hand (DASH) scores at 3, 6, and 12 months.ResultsThere were 32 males and five females. Mean age was 46.0 ± 10.0 years. The cause of injury included car accident, fall, high fall, and bruising. At 3 months, compared with the straight reconstruction locking plate group, the Y-type locking plate group showed higher CSF scores (82.9 ± 3.5 vs. 79.3 ± 4.4, P = 0.01) and lower DASH scores (9.5 ± 2.5 vs. 12.7 ± 3.9, P = 0.008). There were no differences at 6 and 12 months. There were no differences between the two groups regarding intraoperative blood loss (P = 0.65) and operation time (P = 0.634). There were no complications such as plate rupture and screw prolapse during the 1-year follow-up.ConclusionsOpen reduction using the distal humeral Y-type locking plate can achieve better short-term functional outcomes (3 months) than the straight reconstruction locking plate for severe displaced scapular body and neck fractures, but outcomes are similar at 6 and 12 months. Level of evidence: II-2.
Highlights
This study aimed to compare the functional outcomes of the Y-type locking plate with the straight reconstruction locking plate for severe displaced scapular fractures
Most of the scapular fractures are treated with conservative treatment [6, 9–11], but conservative treatment for severe displaced scapular fractures can lead to shoulder joint dysfunction, chronic pain, and other complications [12, 13]
This study aimed to compare the functional outcomes of the Y-type locking plate vs. the straight reconstruction locking plate for the treatment of severe displaced scapular fractures
Summary
This study aimed to compare the functional outcomes of the Y-type locking plate with the straight reconstruction locking plate for severe displaced scapular fractures. Body and neck fractures account for 62% to 98% of all scapular fractures, respectively [5, 7, 8]. For extra-articular scapular fractures, the rate of poor functional outcome after conservative treatment is 20%, The literature about the internal fixation of scapular fractures presents a wide variety of approaches [3,4,5, 7, 13–16], but the current approaches with locking plates are challenging because of the shape of the scapula, resulting in suboptimal patient outcomes. Clinical observations have shown that most unstable fractures of the scapula are comminuted extra-articular fractures of the scapular body or glenoid neck. The most commonly used plates include locking compression plate, reconstruction plate, T-shape plate, calcaneous deformed plate, and microplate [3,4,5, 7, 13, 15]
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