Abstract
BackgroundWe report our preliminary results using a single approach, the mirror Judet approach, for patients with both ipsilateral scapula and multiple rib fractures.MethodsFive consecutive patients [median age: 56 years (range: 44 ~ 60)] with ipsilateral scapula and multiple rib fractures that met the surgical indications were retrospectively reviewed. A single approach, the mirror Judet approach, was used for surgical stabilization of the scapula and targeted rib fractures. Thoracoscopic surgery was performed first for management of associated lung lesions and marking the targeted rib. All patients received the same rehabilitation protocol and a minimum 12-month follow-up.ResultsAll surgically-fixed fractures eventually united without malunion. No complaints of intercostal neuralgia, infection, or other complications were seen. The mean range of motion in the injured shoulder returned to at least 90% of the contralateral side range. The mean Disabilities of the Arm, Shoulder, and Hand score at the 12th month was 2.0 (range: 0-7). All patients were able to return to their previous work.ConclusionThe mirror Judet approach allows for the surgical stabilization of the ipsilateral scapula and multiple rib fractures using the same approach and provides acceptable functional outcomes in well-selected patients.Level of evidenceLevel IV.
Highlights
We report our preliminary results using a single approach, the mirror Judet approach, for patients with both ipsilateral scapula and multiple rib fractures
Indication and contraindication of mirror Judet approach The indications using the mirror Judet approach for ipsilateral scapula and rib fixation included: (1) fresh fractures, less than two weeks; (2) scapula fractures AO/OTA 14F0.B, F1.B or B, whose main fixation relied on lateral border fixation with or without a simple glenoid fossa fragment; (3) ipsilateral posterior and/or lateral fractures from the fourth to tenth rib
Malunion and nonunion of the scapula fracture were defined according to a previous study [14]: malunion-- displacement >5 mm on AP or scapula Y radiograph, persistent angulation >10° on scapula Y radiograph, or a difference≧10° in glenopolar angle (GPA) compared with the Results The demographic data and surgical information of the five patients are listed in Tables 1 and 2
Summary
We report our preliminary results using a single approach, the mirror Judet approach, for patients with both ipsilateral scapula and multiple rib fractures. Scapula fractures are uncommon [1]. Be that as it may, it has been reported that rib fractures have a high coincidence (up to 52.9%) with scapula fractures in a retrospective study using a national trauma database [2]. There is still no clear surgical indication for. Many different surgical approaches with individual benefits and indications have been proposed in the literature [8, 9]. There is no single approach for both ipsilateral scapula and multiple rib fractures. We report our preliminary results using a single approach, the mirror
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