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Published in: European Journal of Trauma and Emergency Surgery 3/2022

18-02-2021 | Nerve Injury | Original Article

Functional outcomes of internal fixation of scapula fractures due to high-velocity gunshot injuries

Authors: Harun Yasin Tüzün, Ömer Erşen, Arsen Arsenishvili, Selim Türkkan, Mustafa Kürklü

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2022

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Abstract

Background

Open fractures of the scapula are relatively rare and only a few studies are interested in this subject. This study aims to demonstrate the results of internal fixation of open scapula fractures due to gunshot injuries.

Materials and methods

Eight patients who had open scapula fractures and were treated by internal fixation through the conventional Judet approach included in this study. Patients were followed up monthly in the first 6 months and every 2 months in the rest of the follow-up. Shoulder range of motion, Constant Shoulder Score, and Disabilities of the Arm, Shoulder, and Hand score were used for functional evaluation.

Results

The average follow-up period was 34.6 ± 11.9 months. The average time between injuries and the surgery was 10.5 ± 5.1 days. The average shoulder abduction of the patients was 135.6 ± 18.8°, the average forward flexion of the shoulder was 160 ± 19.2°. The average internal and external rotations of the shoulders were 80 ± 14.1° and 63.1 ± 17.3°, respectively. CSS was calculated as 79.8 ± 14.4, and DASH was calculated as 14.1 ± 14.9.

Conclusions

In the treatment of open scapula fractures due to gunshot injuries, an internal fixation is a reliable option and the results were comparable with previous studies.
Literature
1.
go back to reference Hu Y, Shi H, Wang F, Ren G, Cheng R, Zhang Z. Functional outcomes of extra-articular scapula fracture fixation with distal humeral Y-type locking plate: a retrospective study. J Orthop Surg Res. 2019;14(1):176.CrossRef Hu Y, Shi H, Wang F, Ren G, Cheng R, Zhang Z. Functional outcomes of extra-articular scapula fracture fixation with distal humeral Y-type locking plate: a retrospective study. J Orthop Surg Res. 2019;14(1):176.CrossRef
2.
go back to reference Dienstknecht T, Horst K, Pishnamaz M, Sellei RM, Kobbe P, Berner A. A meta-analysis of operative versus nonoperative treatment in 463 scapular neck fractures. Scand J Surg. 2013;102(2):69–76.CrossRef Dienstknecht T, Horst K, Pishnamaz M, Sellei RM, Kobbe P, Berner A. A meta-analysis of operative versus nonoperative treatment in 463 scapular neck fractures. Scand J Surg. 2013;102(2):69–76.CrossRef
3.
go back to reference Coimbra R, Conroy C, Tominaga GT, Bansal V, Schwartz A. Causes of scapula fractures differ from other shoulder injuries in occupants seriously injured during motor vehicle crashes. Injury. 2010;41(2):151–5.CrossRef Coimbra R, Conroy C, Tominaga GT, Bansal V, Schwartz A. Causes of scapula fractures differ from other shoulder injuries in occupants seriously injured during motor vehicle crashes. Injury. 2010;41(2):151–5.CrossRef
4.
go back to reference Panigrahi R, Madharia D, Das DS, Samant S, Biswal MR. Outcome analysis of intra-articular scapula fracture fixation with distal radius plate: a multicenter prospective study. Arch Trauma Res. 2016;5(4):e36406.CrossRef Panigrahi R, Madharia D, Das DS, Samant S, Biswal MR. Outcome analysis of intra-articular scapula fracture fixation with distal radius plate: a multicenter prospective study. Arch Trauma Res. 2016;5(4):e36406.CrossRef
5.
go back to reference Jones CB, Sietsema DL. Analysis of operative versus nonoperative treatment of displaced scapular fractures. Clin Orthop Relat Res. 2011;469(12):3379–89.CrossRef Jones CB, Sietsema DL. Analysis of operative versus nonoperative treatment of displaced scapular fractures. Clin Orthop Relat Res. 2011;469(12):3379–89.CrossRef
6.
go back to reference Herrera DA, Anavian J, Tarkin IS, Armitage BA, Schroder LK, Cole PA. Delayed operative management of fractures of the scapula. J Bone Joint Surg Br. 2009;91(5):619–26.CrossRef Herrera DA, Anavian J, Tarkin IS, Armitage BA, Schroder LK, Cole PA. Delayed operative management of fractures of the scapula. J Bone Joint Surg Br. 2009;91(5):619–26.CrossRef
7.
go back to reference Roberts DC, Power DM, Stapley SA. A review of 10 years of scapula injuries sustained by UK military personnel on operations. J R Army Med Corps. 2018;164(1):30–4.CrossRef Roberts DC, Power DM, Stapley SA. A review of 10 years of scapula injuries sustained by UK military personnel on operations. J R Army Med Corps. 2018;164(1):30–4.CrossRef
8.
go back to reference McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980;20(10):880–3.CrossRef McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980;20(10):880–3.CrossRef
9.
go back to reference Gottschalk HP, Browne RH, Starr AJ. Shoulder girdle: patterns of trauma and associated injuries. J Orthop Trauma. 2011;25(5):266–71.CrossRef Gottschalk HP, Browne RH, Starr AJ. Shoulder girdle: patterns of trauma and associated injuries. J Orthop Trauma. 2011;25(5):266–71.CrossRef
10.
go back to reference Goss TP. Scapular fractures and dislocations: diagnosis and treatment. J Am Acad Orthop Surg. 1995;3(1):22–33.CrossRef Goss TP. Scapular fractures and dislocations: diagnosis and treatment. J Am Acad Orthop Surg. 1995;3(1):22–33.CrossRef
11.
go back to reference Salimi J, Khaji A, Karbakhsh M, Saadat S, Eftekhar B. Scapular fracture: lower severity and mortality. Sao Paulo Med J. 2008;126(3):186–9.CrossRef Salimi J, Khaji A, Karbakhsh M, Saadat S, Eftekhar B. Scapular fracture: lower severity and mortality. Sao Paulo Med J. 2008;126(3):186–9.CrossRef
12.
go back to reference Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg Br. 1984;66(5):725–31.CrossRef Hardegger FH, Simpson LA, Weber BG. The operative treatment of scapular fractures. J Bone Joint Surg Br. 1984;66(5):725–31.CrossRef
13.
go back to reference McGinnis M, Denton JR. Fractures of the scapula: a retrospective study of 40 fractured scapulae. J Trauma. 1989;29(11):1488–93.CrossRef McGinnis M, Denton JR. Fractures of the scapula: a retrospective study of 40 fractured scapulae. J Trauma. 1989;29(11):1488–93.CrossRef
14.
go back to reference Schroder LK, Gauger EM, Gilbertson JA, Cole PA. Functional outcomes after operative management of extra-articular glenoid neck and scapular body fractures. J Bone Joint Surg Am. 2016;98(19):1623–30.CrossRef Schroder LK, Gauger EM, Gilbertson JA, Cole PA. Functional outcomes after operative management of extra-articular glenoid neck and scapular body fractures. J Bone Joint Surg Am. 2016;98(19):1623–30.CrossRef
15.
go back to reference Cole PA, Freeman G, Dubin JR. Scapula fractures. Curr Rev Musculoskelet Med. 2013;6(1):79–87.CrossRef Cole PA, Freeman G, Dubin JR. Scapula fractures. Curr Rev Musculoskelet Med. 2013;6(1):79–87.CrossRef
16.
go back to reference Noguchi T, Mautner JF, Duncan SFM. Dorsal plate fixation of scapular fracture. J Hand Surg Am. 2017;42(10):843.CrossRef Noguchi T, Mautner JF, Duncan SFM. Dorsal plate fixation of scapular fracture. J Hand Surg Am. 2017;42(10):843.CrossRef
17.
go back to reference Hu C, Zhang W, Qin H, Shen Y, Xue Z, Ding H, et al. Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases. Arch Orthop Trauma Surg. 2015;135(2):193–9.CrossRef Hu C, Zhang W, Qin H, Shen Y, Xue Z, Ding H, et al. Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases. Arch Orthop Trauma Surg. 2015;135(2):193–9.CrossRef
18.
go back to reference Ideberg R, Grevsten S, Larsson S. Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand. 1995;66(5):395–7.CrossRef Ideberg R, Grevsten S, Larsson S. Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand. 1995;66(5):395–7.CrossRef
19.
go back to reference Lewis S, Argintar E, Jahn R, Zusmanovich M, Itamura J, Rick Hatch GF. Intra-articular scapular fractures: outcomes after internal fixation. J Orthop. 2013;10(4):188–92.CrossRef Lewis S, Argintar E, Jahn R, Zusmanovich M, Itamura J, Rick Hatch GF. Intra-articular scapular fractures: outcomes after internal fixation. J Orthop. 2013;10(4):188–92.CrossRef
20.
go back to reference Obremskey WT, Lyman JR. A modified judet approach to the scapula. J Orthop Trauma. 2004;18(10):696–9.CrossRef Obremskey WT, Lyman JR. A modified judet approach to the scapula. J Orthop Trauma. 2004;18(10):696–9.CrossRef
21.
go back to reference Ao R, Yu B, Zhu Y, Jiang X, Shi J, Zhou J. Single lateral versus medial and lateral plates for treating displaced scapular body fractures: a retrospective comparative study. J Shoulder Elbow Surg. 2018;27(2):231–6.CrossRef Ao R, Yu B, Zhu Y, Jiang X, Shi J, Zhou J. Single lateral versus medial and lateral plates for treating displaced scapular body fractures: a retrospective comparative study. J Shoulder Elbow Surg. 2018;27(2):231–6.CrossRef
22.
go back to reference Anavian J, Gauger EM, Schroder LK, Wijdicks CA, Cole PA. Surgical and functional outcomes after operative management of complex and displaced intra-articular glenoid fractures. J Bone Joint Surg Am. 2012;94(7):645–53.CrossRef Anavian J, Gauger EM, Schroder LK, Wijdicks CA, Cole PA. Surgical and functional outcomes after operative management of complex and displaced intra-articular glenoid fractures. J Bone Joint Surg Am. 2012;94(7):645–53.CrossRef
23.
go back to reference Adam FF. Surgical treatment of displaced fractures of the glenoid cavity. Int Orthop. 2002;26(3):150–3.CrossRef Adam FF. Surgical treatment of displaced fractures of the glenoid cavity. Int Orthop. 2002;26(3):150–3.CrossRef
24.
go back to reference Warrender WJ, Lucasti CJ, Chapman TR, Ilyas AM. Antibiotic management and operative debridement in open fractures of the hand and upper extremity: a systematic review. Hand Clin. 2018;34(1):9–16.CrossRef Warrender WJ, Lucasti CJ, Chapman TR, Ilyas AM. Antibiotic management and operative debridement in open fractures of the hand and upper extremity: a systematic review. Hand Clin. 2018;34(1):9–16.CrossRef
25.
go back to reference Nork SE, Barei DP, Gardner MJ, Schildhauer TA, Mayo KA, Benirschke SK. Surgical exposure and fixation of displaced type IV, V, and VI glenoid fractures. J Orthop Trauma. 2008;22(7):487–93.CrossRef Nork SE, Barei DP, Gardner MJ, Schildhauer TA, Mayo KA, Benirschke SK. Surgical exposure and fixation of displaced type IV, V, and VI glenoid fractures. J Orthop Trauma. 2008;22(7):487–93.CrossRef
26.
go back to reference Lopiz Y, García-Fernández C, Arriaza A, Rizo B, Marcelo H, Marco F. Midterm outcomes of bone grafting in glenoid defects treated with reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2017;26(9):1581–8.CrossRef Lopiz Y, García-Fernández C, Arriaza A, Rizo B, Marcelo H, Marco F. Midterm outcomes of bone grafting in glenoid defects treated with reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2017;26(9):1581–8.CrossRef
27.
go back to reference Robinson CM, Court-Brown CM. Non-union of scapula spine fracture treated by bone graft and plate fixation. Injury. 1993;24(6):428–9.CrossRef Robinson CM, Court-Brown CM. Non-union of scapula spine fracture treated by bone graft and plate fixation. Injury. 1993;24(6):428–9.CrossRef
28.
go back to reference Deng L, Yu A, Qi B, Lei J, De Souza C, Zhu S, Yu L. The Masquelet technique combined with the muscle flap for use in emergency management of acute Gustilo type III trauma of the lower limb with segmental bone loss: Case series. Int J Surg. 2020;81:85–93.CrossRef Deng L, Yu A, Qi B, Lei J, De Souza C, Zhu S, Yu L. The Masquelet technique combined with the muscle flap for use in emergency management of acute Gustilo type III trauma of the lower limb with segmental bone loss: Case series. Int J Surg. 2020;81:85–93.CrossRef
29.
go back to reference Kostretzis L, Theodoroudis I, Boutsiadis A, Papadakis N, Papadopoulos P. Suprascapular nerve pathology: a review of the literature. Open Orthop J. 2017;28(11):140–53.CrossRef Kostretzis L, Theodoroudis I, Boutsiadis A, Papadakis N, Papadopoulos P. Suprascapular nerve pathology: a review of the literature. Open Orthop J. 2017;28(11):140–53.CrossRef
30.
go back to reference Stanec S, Tonković I, Stanec Z, Tonković D, Dzepina I. Treatment of upper limb nerve war injuries associated with vascular trauma. Injury. 1997;28(7):463–8.CrossRef Stanec S, Tonković I, Stanec Z, Tonković D, Dzepina I. Treatment of upper limb nerve war injuries associated with vascular trauma. Injury. 1997;28(7):463–8.CrossRef
31.
go back to reference Vayvada H, Demirdover C, Menderes A, Yilmaz M, Karaca C. The functional results of acute nerve grafting in traumatic sciatic nerve injuries. Ulus Travma Acil Cerrahi Derg. 2013;19(2):109–14.CrossRef Vayvada H, Demirdover C, Menderes A, Yilmaz M, Karaca C. The functional results of acute nerve grafting in traumatic sciatic nerve injuries. Ulus Travma Acil Cerrahi Derg. 2013;19(2):109–14.CrossRef
Metadata
Title
Functional outcomes of internal fixation of scapula fractures due to high-velocity gunshot injuries
Authors
Harun Yasin Tüzün
Ömer Erşen
Arsen Arsenishvili
Selim Türkkan
Mustafa Kürklü
Publication date
18-02-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-021-01614-2

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