Scapular Fractures: Diagnosis and Treatment Plan

Timothy B. Alton; Michael J. Gardner

Disclosures

Curr Orthop Pract. 2015;26(2):99-104. 

In This Article

Imaging

Standard trauma radiographs for the shoulder include the anteroposterior projection (AP, sometimes referred to as the Grashey view), lateral (scapular Y), and the axillary view. These should be obtained for all patients with scapular fractures. The role of two-dimensional (2D) and 3D CT scans in scapular fracture management is expanding, as plain radiographs do not provide an optimal view of the scapula.[25] CT scans of the scapula should be obtained if plain films demonstrate displacement that may warrant operative intervention.

Chochola et al.[26] also described the utility of CT scans for accurate diagnosis of scapular fractures and believe the use of 3D CT is necessary to determine the exact location and extent of fracture. Anavain et al.[27] determined CT scans were more reliable and had better inter- and intraobserver reliability than plain radiographs in the assessment of glenopolar angle, angulation, and translation of scapular fractures. A study by Bartonicek et al.[28] supported this finding. Many patients with scapular fractures already have had chest CT scans, and reformatted 3D reconstructions can often be reconstructed from these previously acquired imaging studies.

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