PMC6791266_01
AP and lateral radiographic views of the scapula showing a comminuted and displaced fracture of the scapular spine and body with an avulsion of the acromion base.
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Radiographs showed a comminuted and displaced fracture of the scapular spine and body with an avulsion of the acromion base (Figure 1).
Computed tomography 3-dimensional reconstruction of the scapula showing a segmental fracture of the entire superior aspect including the acromion along with free-floating fragments of its base and spine.
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Computed tomography 3-dimensional reconstruction revealed no glenoid involvement but a segmental fracture of the entire superior aspect of the scapula, including the acromion base and spine, which were free-floating fragments (Figure 2).
Intraoperative view of the temporary reduction of scapular spine fracture with forceps.
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After adequate exposure, the posterior portion of the acromion was reduced to the scapular body with point of reduction clamps and stabilized with 2.7 mm lag screws (Figures 3 and 4).
2.7 mm lag screws and K-wires were used to provide temporary fixation and alignment of the scapular spine fracture.
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After adequate exposure, the posterior portion of the acromion was reduced to the scapular body with point of reduction clamps and stabilized with 2.7 mm lag screws (Figures 3 and 4).
Intraoperative view of the placement of the Zimmer-Biomet elbow plate which matched the contour of the spine of the scapula.
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Temporary reduction of the fractured scapular spine to the acromion was achieved with K-wires, and then, a Zimmer Biomet elbow plate was placed for definitive fixation (Figure 5).
Intraoperative views showing our final plating construct which was supported with multiple cortical screws from superior and posterior to anterior and inferior.
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The curvature of the elbow plate matched the curvature of the acromion, and we were able to place multiple cortical screws from superior and posterior to anterior and inferior (Figure 6).
Postoperative computed tomography 3-dimensional reconstruction of the scapula showing our plate fixation of the scapular spine fracture.
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Her last radiographic assessment showed maintained alignment of the acromion process without implant failure (Figures 7 and 8).
AP and lateral radiographic views of the scapula showing our fracture in appropriate alignment with evidence of implant failure or loosening.
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Her last radiographic assessment showed maintained alignment of the acromion process without implant failure (Figures 7 and 8).