The Journal of Bone and Joint Surgery, Vol 59, Issue 3 358-362, Copyright © 1977 by Journal of Bone and Joint Surgery, Inc
Fractures of the scapula. An analysis of forty cases and a review of the literature
MC Wilber and EB Evans
In forty patients treated at The University of Texas Medical Branch
Hospitals for fifty-two fractures of forty-one scapulae from 1961 through
1973, most of the fractures were the result of vehicular accidents. The
thirty-eight fractures involving only the body, neck, or spine of thirty
scapulae (without involvement of the acromion, glenoid, or coracoid
process) were successfully treated with a sling and early active motion.
Three other fractures involving body were associated with three fractures
involving the glenoid. The eleven fractures of the acromiom, glenoid, or
coracoid process resulted in loss of motion in ten of the eleven shoulders.
For fractures of this type we now recommend immobilization in 60 degrees of
abduction, 25 degrees of flexion, and 25 degrees of external rotation, with
early active abduction exercises. Open reduction is rarely indicated, only
when there is disruption of the glenohumeral joint.