Abstract: Introduction: Since long ago the scapula fracture is treated conservatively and most of time it works because scapula is a flat bone and coated with bulky muscle. So, nonunion of the fracture is usually not a problem, and most of time, due to very high arc of motion of shoulder joint, even in malunited fractures, mild to moderate restriction of the range of motion not create significant problem. But the actual problem comes when fracture through the glenoid neck or glenoid fossa cause derangement in the biomechanics of shoulder joint, or associated fracture of clavicle – ‘The floating shoulder’ cause significant instability of shoulder joint. Recent advances and proper understanding of the biomechanics of the shoulder joints open a new chapter of operative management for better quality of life.
In this study we retrospectively tried to understand that which fractures can be treated conservatively and which one require fixation.
Aim: To study retrospectively extraarticular glenoid neck fractures of scapula (a study of 20 cases).
Materials and Methods: Total 20 patients having extra articular scapular neck fracture, with following criteria are included in this study. All patients were treated by consultant orthopedic surgeons of the department of orthopedics of Guru Gobindsingh Hospital, Jamnagar only. All patients are evaluated retrospectively. Patients having fracture of appendicles (Fracture of acromion, coracoid and spine), body as well as intra articular glenoid fracture were not included in this study. So this study was concerned only with stable and unstable scapular neck fracture. All patients are evaluated with Herscovici shoulder scoring system to make this study comparable with other study universally.
Results: Our study shows excellent results in 16 out of 20 scapular fractures as well as 4 good results, according to Herscovici shoulder scoring system. Most common complication is subacromial pain especially at night while sleeping on that side. Incidence of mild exertional pain is 45% while loss of useful abduction was 10% and superficial infection is 5%.
Conclusion: To conclude, this rare type of fracture has high incidence of significant associated injury. Among all scapular fractures extra articular displaced glenoid fracture and floating shoulder type injury should get special attention regards of its treatment, because closed observation and intelligence can make vast change in its outcome.
