Gleno-humeral Joint Functional Outcome in Displaced Scapular Body Fracture Treated with Anatomical Scapula Plate: 2 case series

Introduction: The gleno-humeral (GH) or shoulder joint complexity of its biomechanics had been subjected for a number of study for many years. The ability of the shoulder joint to have multiple degrees of motion is contributed by the interaction between the structures surrounding the joint which maintain its stability. Methods: We report 2 cases of displaced scapular body fracture in our trauma centre fixed using anatomical scapular plate. Both underwent surgery within 3 weeks after their accident, using modified Judet approach and used implant from the same provider. All patients were followed up at 6, 12 , 18 and 72 weeks. At 6 months post operation the motion of the gleno-humeral joint were assessed. The functional status and pain score were joint also assessed using QuickDASH score and Visual Analogue Scale respectively. Results: Active shoulder range of motion, QuickDASH and VAS score are shown in Table 1. Lower QuickDASH score have better functional outcome while lower VAS score indicate lesser pain experience. Table 1. (N: Normal) Patient Abduction (N: 0-180) Forward Flexion (N:0-180) International Rotation (N:0-60) External Rotation (N:0-90) QuickDASH Vas A 0-150 0-150 0-40 0-60 50 3 B 0-160 0-160 0-50 0-70 48 2 Discussions: Scapulo-thoracic joint also important in gleno-humeral joint motion. Scapulothoracic motion allows shoulder movement beyond initial 120o provided by the glenohumeral joint1. This coordinated movement between the scapula-thoracic and glenohumeral joint is termed as scapula-thoracic rhythm2. Displaced scapula fracture will affect the function of the scapula-thoracic rhtym. Scapula bone has uneven bony mass distribution. Anatomical scapular plate is a pre-contoured implant which is specially designed to meet the morphology of the scapula bone. Restoration of the anatomy of the scapula is very important since it will restore the scapula-thoracic rhythm and thus gleno-humeral joint function. Conclusion: In our short follow up, displaced scapular body fracture shows good gleno-humeral joint functional outcome when treated with anatomical scapula plate. Scapula bone plays important role in maintaining the biomechanics of gleno-humeral joint. References: 1. Terry GC, Chopp TM. Functional anatomy of the shoulder. J Athlet Train 2000;35(3):248–55. 2.Halder AM, Itoi E, An K. Anatomy and biomechanics of the shoulder. Orthop Clin NA 2000;31(2).