The relationship between scapular fractures and concomitant injuries

Abstract

Objective To study the relationship between the fractured scapular location, the number of fractured scapular regions and the distribution and severity of associated injuries in patients with multiple trauma. Methods One hundred and fifteen consecutive patients with fractured scapula were retrospectively studied between August 2006 and March 2008. There were 96 males and 19 female with an average age of 37.9 years. Mechanism of injury, associated injuries, abbreviated injury soore (AIS) for each part, injury severity score (ISS), and the location and the number of anatomic scapular regions involved in each fracture were studied. Patients were divided into single-region fracture (SRF) group and multiple-region fracture (MRF) group. Furthermore, the SRF group was subdivided into three groups according to their anatomic location: 1) the muscle covered part, 2) the apophyseal part and 3) the glenoid part. Computer tomography and plain radiographs was used for fracture classification in all patients. Results Most scapular fractures were a part of severe multiple trauma, with mean ISS 14.0 among them 42 cases (36.5%) were greater than 16. Road traffic accident was the most common cause for scapular fracture. Ninety-eight patients (85.2%) sustained associated injury. The most frequent part involved was chest(85/115, 73.9%). ISS and AIS for the chest injuries were higher in patients with multiple scapular fractures or scapular fractures in muscle covered part. Conclusion Scapular fractures are usually caused by directly high energy trauma, accompanied by associated injuries. The most frequent region was chest injury. MRF may serve as an external skeletal marker of severe chest injury. Key words: Shoulder fractures; Scapula; Wounds and injuries; Thorax