Scapular fractures

Abstract

Scapular fractures are common in polytraumatized patients and should alert treating providers to investigate for additional severe, often life-threatening injuries. While many fractures can be treated nonoperatively, surgical intervention is required if fractures are widely displaced or involve significant portions of the glenoid articular surface. The osseous anatomy of the scapula is complicated and thin, which dictates fixation options. Many classifications exist for scapular fractures and, while the AO/OTA recently contributed the New International Classification for Scapular Fractures, surgical indications remain loosely defined. Advanced imaging, such as three-dimensional CT scans, help in the diagnosis and surgical planning. The glenoid and scapular neck can be approached anterior, via the deltopectoral interval, while the posterior scapula is accessed through the modified Judet approach.