Il trattamento delle fratture “complesse“ di scapola, del collo scapolare e della “floating shoulder

ISSN： 0390-7368

Source： Archivio di Ortopedia e Reumatologia, Vol.122, Iss.1, 2011-06, pp. : 27-30

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Abstract

Most scapular fractures present a complex association of damage involving the scapular body, the scapular neck, the clavicle or ligaments between scapula and clavicle, as observed in the “floating shoulder, and, finally, fractures of the glenoid articular surface. These fractures require an accurate evaluation with 3D-CT imaging. In our approach the first aim is the best possible reconstruction and stabilization of the articular surface of the glenoid (by means of arthroscopic or open techniques), followed by the stabilization of a floating shoulder (mainly with ORIF of the clavicle) and finally, the ORIF of the scapular neck and body in case of severe displacement, but with a good bone stock suitable for osteosynthesis with plate and screws. This approach is based on the evidence that defects of the glenoid articular surface can lead to painful instability or mid-term degenerative arthritis, the “floating shoulder increases the painful instability and deformity of the scapular neck, while moderate displacements of the neck or the body rarely cause pain and relevant scapulo-humeral dysfunction.