Treatment of the Ipsilateral Fractures of the Scapular Neck and Clavicle

Choy, Won Sik; Lee, Kwang Woo; Kim, Young Wan; Hwang, In Sung; Tak, Sang Bo

Abstract

Scapular fractures are being seen with increasing frequency in our mechanized society, specially in patients who have multiple injuries. Most of the scapular fractures have been treated non-operatively, with early mobilization of the shoulder. The result of such functional treatment have been predictably good. However, this non-operative approach may not yield such good results in patients who have a fracture of the scapular neck in association with the ipsilateral clavicular fracture or other double disruptions of the superior shoulder suspensory complex. Ipsilateral fractures of the scapular neck and clavicle disrupt the suspensory mechanism of the shoulder resulting in fuctional loss and deformity. From January 1989 to June 1995, twelve patients were identified with this specific pattern of injury. The follow up period was 39.2 months in average. Seven patients were treated operatively using 3.5mm DCP or reconstruction plate, and five patients were performed K-wire fixation or wiring. Upon review all were healed radiographically. According to the scoring system of Rowe, five patients had an excellent fuctional result, five had a good result, and two had a fare result. The average score for the twelve patients was 85 points. The results of our retrospective study show that operative treatment for these complex fractures is safe and that functional recovery is predictably good.