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Clinical Orthopaedics and Related Research®

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01-05-2009 | Case Report

Case Report: Reconstruction of a Recalcitrant Scapular Neck Nonunion and Literature Review

Authors: Daniel J. Marek, MD, V. Franklin Sechriest II, MD, Marc F. Swiontkowski, MD, Peter A. Cole, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 5/2009

Abstract

We present the first reported treatment failure of a reconstructed scapula body that proceeded to nonunion. This is a unique case report of an otherwise healthy patient who underwent open reduction and internal fixation of a scapula fracture nonunion, which is very rare. Failure of internal fixation in this application has not been reported, and, to our knowledge, this is only the fifth case report of a scapula body nonunion that was reconstructed. Of 159 reported cases of open reduction and internal fixation for treatment of scapula neck and body fractures (with or without intraarticular glenoid fractures), there is not one reported case of a nonunion. Our case is described in detail, including the method of surgical reconstruction, and a review of the literature regarding surgical treatment of scapula nonunions after nonoperative treatment also is presented.

Ada JR, Miller ME. Scapular fractures: analysis of 113 cases. Clin Orthop Relat Res. 1991;269:174–180.PubMed

Bauer G, Fleischmann W, Dussler E. Displaced scapular fractures: indication and long-term results of open reduction and internal fixation. Arch Orthop Trauma Surg. 1995;114:215–219.PubMedCrossRef

Boerger TO, Limb D. Suprascapular nerve injury at the spinoglenoid notch after glenoid neck fracture. J Shoulder Elbow Surg. 2000;9:236–237.PubMedCrossRef

Bohm P. Pseudarthrosis of the spine of the scapula: case report of a minimally invasive osteosynthesis technique. Acta Orthop Scand. 1998;69:645–647.PubMed

Charlton WP, Kharazzi D, Alpert S, Glousman RE, Chandler RW. Unstable nonunion of the scapula: a case report. J Shoulder Elbow Surg. 2003;12:517–519.PubMedCrossRef

Cole PA. Scapula fractures: open reduction internal fixation. In: Wiss D, ed. Master Techniques in Orthopaedic Surgery, Fractures. 2nd Ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:15–36.

Cole PA, Marek DA. Shoulder girdle injuries. In: Stannard JP, Schmidt AH, Kregor PJ, eds. Surgical Treatment of Orthopaedic Trauma. New York, NY: Thieme Medical Publishers, Inc; 2007:207–236.

Darrach W. Fractures of the acromion process of the scapula. Ann Surg. 1914;59:455–456.

Dounchis JS, Pedowitz RA, Garfin SR. Symptomatic pseudarthrosis of the acromion: report of a case and review of the literature. J Orthop Trauma. 1999;13:63–66.PubMedCrossRef

10.

Egol KA, Connor PM, Karunakar MA, Sims SH, Bosse MJ, Kellam JF. The floating shoulder: clinical and functional results. J Bone Joint Surg Am. 2001;83:1188–1194.PubMed

11.

Ferraz IC, Papadimitriou NG, Sotereanos DG. Scapular body nonunion: a case report. J Shoulder Elbow Surg. 2002;11:98–100.PubMedCrossRef

12.

Garcia-Elias M, Salo JM. Non-union of a fractured coracoid process after dislocation of the shoulder: a case report. J Bone Joint Surg Br. 1985;67:722–723.PubMed

13.

Gupta R, Sher J, Williams GR Jr, Iannotti JP. Non-union of the scapular body: a case report. J Bone Joint Surg Am. 1998;80:428–430.PubMedCrossRef

14.

Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg Br. 1984;66:725–731.PubMed

15.

Herscovici D Jr, Sanders R, DiPasquale T, Gregory P. Injuries of the shoulder girdle. Clin Orthop Relat Res. 1995;318:54–60.PubMed

16.

Kaminsky SB, Pierce VD. Nonunion of a scapula body fracture in a high school football player. Am J Orthop. 2002;31:456–457.PubMed

17.

Kavanagh BF, Bradway JK, Cofield RH. Open reduction and internal fixation of displaced intra-articular fractures of the glenoid fossa. J Bone Joint Surg Am. 1993;75:479–484.PubMed

18.

Khallaf F, Mikami A, Al-Akkad M. The use of surgery in displaced scapular neck fractures. Med Princ Pract. 2006;15:443–448.PubMedCrossRef

19.

Labler L, Platz A, Weishaupt D, Trentz O. Clinical and functional results after floating shoulder injuries. J Trauma. 2004;57:595–602.PubMedCrossRef

20.

Lantry JM, Roberts CS, Giannoudis PV. Operative treatment of scapular fractures: a systematic review. Injury. 2008;39:271–283.PubMedCrossRef

21.

Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle. J Bone Joint Surg Am. 1993;75:1015–1018.PubMed

22.

Mayo KA, Benirschke SK, Mast JW. Displaced fractures of the glenoid fossa: results of open reduction and internal fixation. Clin Orthop Relat Res. 1998;347:122–130.PubMedCrossRef

23.

McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980;20:880–883.PubMedCrossRef

24.

McGinnis M, Denton JR. Fractures of the scapula: a retrospective study of 40 fractured scapulae. J Trauma. 1989;29:1488–1493.PubMedCrossRef

25.

Michael D, Fazal MA, Cohen B. Nonunion of a fracture of the body of the scapula: case report and literature review. J Shoulder Elbow Surg. 2001;10:385–386.PubMedCrossRef

26.

Mick CA, Weiland AJ. Pseudarthrosis of a fracture of the acromion. J Trauma. 1983;23:248–249.PubMedCrossRef

27.

Naested J, Jorgensen U, Torholm C. Pseudoarthrosis of the acromion: a differential diagnosis in anterolateral shoulder pain. Scand J Med Sci Sports. 1995;5:105–106.PubMedCrossRef

28.

Newell ED. Review of over two thousand fractures in past seven years. South Med J. 1927;20:644–648.

29.

Ogawa K, Naniwa T. Fractures of the acromion and the lateral scapular spine. J Shoulder Elbow Surg. 1997;6:544–548.PubMedCrossRef

30.

Oh W, Jeon IH, Kyung S, Park C, Kim T, Ihn C. The treatment of double disruption of the superior shoulder suspensory complex. Int Orthop. 2002;26:145–149.PubMedCrossRef

31.

Robinson CM, Court-Brown CM. Non-union of scapula spine fracture treated by bone graft and plate fixation. Injury. 1993;24:428–429.PubMedCrossRef

32.

Rowe CR. Fractures of the scapula. Surg Clin North Am. 1963;43:1565–1571.PubMed

33.

Schandelmaier P, Blauth M, Schneider C, Krettek C. Fractures of the glenoid treated by operation: a 5- to 23-year follow-up of 22 cases. J Bone Joint Surg Br. 2002;84:173–177.PubMedCrossRef

34.

Schwartzbach CC, Seoudi H, Ross AE, Hendershot K, Robinson L, Malekzadeh A. Fracture of the scapula with intrathoracic penetration in a skeletally mature patient: a case report. J Bone Joint Surg Am. 2006;88:2735–2738.PubMedCrossRef

35.

Wilber MC, Evans EB. Fractures of the scapula: an analysis of forty cases and a review of the literature. J Bone Joint Surg Am. 1977;59:358–362.PubMed

36.

Wilson PD. Experience of the Management of Fractures and Dislocations (Based on Analysis of 4,390 Cases) by Staff of the Fracture Service MGH, Boston. Philadelphia, PA: JB Lippincott; 1938.

Title: Case Report: Reconstruction of a Recalcitrant Scapular Neck Nonunion and Literature Review
Authors: Daniel J. Marek, MD
V. Franklin Sechriest II, MD
Marc F. Swiontkowski, MD
Peter A. Cole, MD
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 5/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-008-0651-3

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Case Report: Reconstruction of a Recalcitrant Scapular Neck Nonunion and Literature Review

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