Scapula

Scapula fractures are of increasing interest as a result of new clinical and scientific discovery. Historically treated with benign neglect, scapula fractures were thought to heal without adverse sequelae, and surgery was untested. Scapula fractures are associated with high energy trauma and occur with other injuries in 90% of cases, most commonly including injuries to the ipsilateral extremity (50%) and thorax (80%). Stabilization of highly displaced fractures is associated with consistently positive results. Greater discussion of operative indications has brought about interest in defining displacement and angulation via 3-dimensional radiography. Glenopolar angle, medialization, angulation, version, and translation, are terms by which fracture displacement is assessed. Displaced double lesions of the shoulder suspensory complex and intra articular glenoid stepoff define well accepted indications. Symptomatic scapula malunions occur, and should underscore the need for critical workup and possible intervention of a subset of these patients.