Surgical management of scapular fractures

Abstract

Scapula fractures are rare and historically have been treated effectively with nonsurgical methods. There is a paucity of literature and limited practical experience regarding surgical indications and intervention for this entity. The indications for surgical intervention are still unclear but are becoming better defined. The operative approaches are refined and include either a standard anterior deltopectoral approach or a posterior approach. The latter involves detachment of the deltoid from the spine of the scapula and development of the interval between the infraspinatus and teres minor muscles. Accurate reduction of the articular surface is crucial, and internal fixation should be varied in relation to the size and location of the fracture fragments. The stability of the fixation should allow for early or slightly delayed motion in order to allow soft tissue, musculotendinous, and capsule healing.