We report a complex combined glenoid, acromial, and coracoid fracture that caused incomplete infraspinatus paralysis. This proved to be due to transection of one trunk of a duplicated suprascapular nerve at the spinoglenoid notch. Open reduction and internal fixation included a modified tension band wiring technique previously not described for acromial fractures. This further anatomic variation reiterates the need for caution in the placement of arthroscopic portals and the need to be aware that neurovascular anatomy may be unique and not follow patterns previously described. Peripheral nerve injuries as a direct result of scapular fractures are extremely rare. More commonly associated neurologic deficits are a result of brachial plexus injury.2,4 We report a case of displaced scapular neck fracture causing an isolated incomplete infraspinatus paralysis by transecting the major division of a duplicated suprascapular nerve. In this case the suprascapular nerve presented an anatomic variant and was found as 2 branches at the spinoglenoid notch. CASE REPORT A 29-year-old man was admitted to our department after trapping his left arm in a paper-rolling machine. Severe soft-tissue injuries with circumferential degloving of the left forearm and crushing of the left hand resulted. Radiographs revealed a radial styloid fracture, ipsilateral fractures of the acromion, the scapular neck, and the coracoid, and dislocation of the acromioclavicular joint (Figure 1). Debridement and split skin grafting of the forearm were carried out. After imaging was performed with 3-dimensional computed tomography reconstruction (Figure 2), the left scapula fracture was treated by open reduction and internal fixation 17 days after the injury occurred. With Judet’s approach, with anterior extension over the acromion, the infraspinatus was raised from its fossa to expose its neurovascular pedicle. The glenoid fragment was found to be rotated to face forward and was locked in the spinoglenoid notch. At the fracture site the larger of 2 divisions of the suprascapular nerve had been transected. A decision