Background: Interest in operative management of scapular fractures is increasing based upon defined radiographic displacement criteria and growing awareness that certain extra-articular fractures will not do well and result in dysfunction and deformity (slumped shoulder). We intend to quantify clinical deformity, analyze correlations of these novel measures with defined radiographic measures of fracture displacement and with the patients’ reported perception of their deformity. Methods: Prospectively enrolled patients underwent standardized questioning regarding their perception of the deformity. Radiographs were utilized to measure glenopolar angle medial/lateral displacement, and angulation of the displaced scapula fracture. Novel measurements of clinical deformity (shoulder area, shoulder angle and shoulder height difference) were calculated. All measurements were repeated post-operatively for patients undergoing operative treatment. Results: Fifty-one patients (39 operative) were examined within 30 days of injury. Follow-up (≥2 months post-op) was obtained for 31/39 (79%). Medial–lateral displacement significantly correlated with all measures of clinical deformity and with patient reported shoulder appearance bothersome score. Angulation significantly correlated with patient perception and two clinical measures (shoulder area and shoulder angle difference). All post-operative radiographic measures, clinical measures of deformity, and patient reported scores statistically improved from baseline measures. Discussion: Patients with scapula fracture do perceive deformity, and there is a significant correlation between the patients’ perception, radiographic and clinical measurements of deformity after scapula fracture. All measures statistically improved in patients with operative treatment compared to baseline measurements. This study reinforces the importance of the clinicians’ clinical examination and observation of shoulder deformity in the scapula fracture patient. Level of evidence: IV
Bibliographical noteFunding Information:
This study was funded through an institutional grant from Stryker, Inc.
Research grant funding for this study was provided by Stryker Orthopaedic. Stryker Orthopaedic did not play a role in this investigation. Peter A Cole, MD reports institutional research grant funding from Depuy Synthes, Stryker, AORF; institutional education grant funding from COTA, AONA, OMeGA; personal honoraria from AO Foundation, and stock ownership of BoneFoams, Inc, all outside the submitted work. For the remaining authors, none were declared. *This study was approved by the Health Partners Research Foundation Institutional Review Board (#12-068). *Illustrations published in color.
Copyright 2020 Elsevier B.V., All rights reserved.
- Patient reported measure
- Scapula fracture
- Shoulder cosmesis
- Shoulder deformity
PubMed: MeSH publication types
- Journal Article