Introduction: Surgical treatment of displaced acromial and scapula spine fractures may be challenging due to the bony anatomy and variable fracture patterns. This difficulty is accentuated by the limitations of the available scapular plates for fracture fixation. This study compares the quantitative fitting of anatomic scapular plates and clavicle plates, using three-dimensional (3D) printed fractured scapulae.
Methods: Fourteen scapulae with acromion and spine fractures were used for this study. Computerized tomographic (CT) scans of the fractured scapulae were obtained from the Philips picture archiving and communication system (PACS) database of patients admitted to a tertiary teaching hospital in Cape Town, South Africa between 2012 and 2016. The reconstructed scapulae were 3D printed and the anatomical acromion and clavicle plates were templated about the fracture regions. The fit assessment was performed by five observers who classified the plates as no-fit, intermediate fit, and anatomical fit according to the surgical guidelines.
Results: The 6-hole anterior clavicle plate performed better than any of the scapular plates as they were able to fit 45.7% of the fractured acromion, including the spine. Among the pre-contoured anatomical scapula plates, both the short and the long acromion plates could fit only 27.3% of the fractured acromion. The intraclass correlation coefficient was 0.965 suggesting excellent consensus among the five observers.
Conclusion: Clavicle plates were found to be better suited to fit around a scapula fracture in its acromion and spine region.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136237 | PMC |
http://dx.doi.org/10.1051/sicotj/2021028 | DOI Listing |
JBJS Essent Surg Tech
December 2024
Department of Orthopedics, OhioHealth Health System, Columbus, Ohio.
Introduction: This article presents a simultaneous operative technique, which allowed to successfully treat a Cuff Tear Arthropathy (CTA), instability and Levy-type III scapular spine fracture non-union with 90°-double plating, humerus-to-scapula grafting and simultaneous reverse shoulder arthroplasty.
Case Report: We present a 64year-old woman with previously known cuff arthropathy (2012/53yo). She fell in 2017 (58 years old with minor shoulder disability) before dislocating the shoulder in 2020 (60 years old) with evidence of a medial Levy-type III scapular spine fracture non-union and severe apprehension, unable to anterior elevate her arm more than 90°.
Plast Reconstr Surg
October 2024
Department of Plastic & Oral and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
Background: The scapular free flap has increasingly gained popularity as an alternative to the fibular free flap in osseous head and neck reconstruction. The present study aimed to evaluate their use in maxillomandibular reconstructions and examine surgical and patient outcomes.
Methods: Osseous head and neck defects reconstructed with an angular artery-based scapular flap or fibular flap from 2016 to 2022 at two Swedish University Hospitals were evaluated for their intraoperative execution (osseous and soft tissue combinations) and postoperative outcomes.
Arthrosc Tech
September 2024
CHP Saint-Gregoire, Saint-Grégoire, France.
Scapular spine fractures following reverse shoulder arthroplasty have been associated with complications that include nonunion and fixation failure. This Technical Note presents a surgical approach for enhancing the stability and strength of spine fracture osteosynthesis. The method involves the utilization of double plating in conjunction with fibular allograft reinforcement anchored in the supraspinous fossa to provide support under the acromion.
View Article and Find Full Text PDFJBJS Essent Surg Tech
August 2024
Western Orthopaedics, P.C., Denver, Colorado.
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