• Z Orthop Unfall · Aug 2018

    Case Reports

    [Arthroscopically Assisted Minimally Invasive Fixation of a Type D2c Scapular Fracture].

    • Patrick Kornherr, Christiane Konerding, Mark Kovacevic, and Klaus Wenda.
    • Klinik für Unfall-, Hand- und Orthopädische Chirurgie, Helios Dr. Horst-Schmidt-Kliniken, Wiesbaden.
    • Z Orthop Unfall. 2018 Aug 1; 156 (4): 443-448.

    AbstractFractures of the scapula are rare and have an incidence of 1% of all fractures. Publications highlight glenoid rim fractures. Classification by Ideberg and Euler and Rüdi are accepted. Euler and Rüdi describe three extra-articular and two intra-articular fracture patterns. The indications for surgery are displaced glenoid fractures, scapula tilt of more than 40° and injuries to the superior shoulder suspensory complex. We describe a case of a 22 year old man, who while cycling collided with a moving car due to wet roads. After his admission to hospital as a polytraumatised patient, the trauma CT-Scan showed haemothorax with several associated rip fractures, displaced humeral shaft fracture and fractures of the acromion and glenoid, classified as type D2c according to Euler and Rüdi. Following damage control principles, drainage of the haemothorax was already performed in the ER and surgical treatment of the displaced humeral shaft fracture was performed on the day of admission. No peripheral neurological deficits were evident. After pulmonary stabilisation, surgery was performed 6 days later on the glenoid and acromion fracture, which in conjunction may be regarded as an injury to the superior shoulder suspensory complex. We performed an arthroscopically-assisted screw fixation of the glenoid fracture (type D2c according to Euler and Rüdi) and an ORIF procedure at the acromion. Postoperative rehabilitation was performed with passive abduction and elevation up to 90° for the first two weeks and active abduction an elevation up to 90° for weeks 3 to 6. Full ROM was allowed at week 7.Georg Thieme Verlag KG Stuttgart · New York.

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