Anatomy of fractures of the inferior scapular angle
Authors:
J. Bartoníček 1; M. Tuček 1; J. Malík 2
Authors‘ workplace:
Klinika ortopedie 1. LF Univerzity Karlovy a ÚVN Praha
1; Oddělení radiologie ÚVN Praha
2
Published in:
Rozhl. Chir., 2018, roč. 97, č. 2, s. 77-81.
Category:
Original articles
Overview
Introduction:
The aim of this study is to describe the anatomy of fractures of the inferior angle and the adjacent part of the scapular body, based on 3D CT reconstructions.
Method:
In a series of 375 scapular fractures, we identified a total of 20 fractures of the inferior angle of the scapular body (13 men, 7 women), with a mean patient age of 50 years (range 33−73). In all fractures, 3D CT reconstructions were obtained, allowing an objective evaluation of the fracture pattern with a focus on the size and shape of the inferior angle fragment, propagation of the fracture line to the lateral and medial borders of the infraspinous part of the scapular body, fragment displacement and any additional fracture of the ipsilateral scapula and the shoulder girdle.
Results:
We identified a total of 5 types of fracture involving the distal half of the infraspinous part of the scapular body. The first type, recorded in 5 cases, affected only the apex of the inferior angle, with a small part of the adjacent medial border. The second type, occurring in 4 cases, involved fractures separating the entire inferior angle. The third type, represented by 4 cases, was characterized by a fracture line starting medially close above the inferior angle and passing proximolaterally. The separated fragment had a shape of a big drop, carrying also the distal half of the lateral pillar in addition to the inferior angle. In the fourth type identified in 5 fractures, the separated fragment was formed both by the inferior angle and a variable part of the medial border. The fifth type, being by its nature a transition to the fracture of the infraspinous part of the body, was recorded in 2 cases, with the same V-shaped fragment.
Conclusion:
Fractures of the inferior angle and the adjacent part of the scapular body are groups of fractures differing from other infraspinous fractures of the scapular body. Although these fractures are highly variable in terms of shape, they have the same course of fracture line and the manner of displacement.
Key words:
scapula − scapula fractures − scapular body fractures − inferior angle − classification of scapular body fractures
Sources
1. Chang AC, Phadnis J, Eardley-Harris N, et al. Inferior angle of scapula fractures: a reviw of literature and evidence-based treatment guidelines. J Shoulder Elbow Surg 2016;25:1170−4.
2. Ada JR, Miller ME. Scapula fractures. Analysis of 113 cases. Clin Orthop Rel Res 1991;269:174−80.
3. Euler E, Habermeyer P, Kohler W, et al. Skapulafrakturen − Klassifikation und Differentialtherapie. Orthopäde 1992;21: 158−62.
4. Euler E, Rüedi T. Skapulafraktur. In Habermeyer P, Schweiberer L (eds). Schulterchirurgie. München, Urban und Schwarzenberg 1996.
5. Orthopaedic Trauma Association. Fracture and dislocation compendium. Scapula fractures. J Orthop Trauma 1996; (Suppl 1): S81−S84.
6. Orthopaedic Trauma Association Fracture and dislocation compendium. Scapular fractures. J Orthop Trauma. 2007; Suppl 1: S68−S71.
7. Audigé L, Kellam JF, Lambert S, et al. The AO Foundation and Orthopaedic Trauma Association (AO/OTA) scapula fracture classification system focus on body involvement. J Shoulder Elbow Surg 2014;23:189−96.
8. Schäfer D. Diagnostik und Klassifikation der Skapulafraktur Bedeutung der 3D-CT-Rekonstruktionen unter Anwendung der neuen AO/OTA-Klassifikation. Inaugural-Dissertation. Hohe Medizinische Fakultät der Universitätzu Köln. Köln 2015.
9. Bartoníček J, Tuček M, Naňka O. Zlomeniny lopatky. Rozhl Chir 2015;94:393−404.
10. Bartoníček J, Klika D, Tuček M. Classification of scapular body fractures. Rozhl Chir 2018;97:67–75. In print.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2018 Issue 2
Most read in this issue
- Fractures of the fifth metatarsal base
- Classification of posterior malleolar fractures in ankle fractures
- Classification of scapular body fractures
- Anatomy of fractures of the inferior scapular angle