Objective: To study the appropriate approach and method of fixation in the surgery for scapular neck displaced fracture.
Methods: Fourteen patients with serious step-off displacement of glenoid rim, with a distance of 3 cm (2 approximately 4 cm) involving fresh scapular neck fracture, all located from the superior scapular notch to glenoid armpit rim and passing through the mesoscapula, all of the type II according to the Miller's system, 10 males and 4 females, aged 33 (21 - 60). The surgical indications included a distance of step-off displacement exceeding 1 cm and a time between the injury and operation of 3 - 10 days.
Results: All operations were successful without injury of nerve and blood vessels. All the wounds obtained primary healing within 6 weeks (4 - 8 weeks). X-ray plain films showed that all cases obtained complete or nearly complete anatomical reduction. Follow-up carried out for 1 - 7 years showed no complication. According to the Hardegger's evaluation, 8 cases showed excellent prognosis, 4 showed good prognosis, and 2 showed fair prognosis.
Conclusion: Operation is necessary for step-off displacement of glenoid rim involving scapular neck fracture. Hard and with regular shape, the mesoscapula and armpit rim suits for fixation. Open reduction through posterior approach and internal fixation in prone position help recover the morphology and biomechanics characteristic of scapula. Propitious to functional recovery, dirigation should begin early.
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