The purpose of this report is to evaluate the results of treatment for fractures of the scapula with associated injuries. This study was composed of 123 patients (130 fractures). One hundred and seven were males and 16 were fenales. Their average age was 44.8 ranging from 3 to 84. The fractures were divided into four types as follows; scapular body: 54 cases, scapular neck: 40 cases, coracoid process: 18 cases, acromion or scapular spine: 18 cases. Seven cases had fractures in more than one location. Eighty-one of the 123 cases (66%) had assoceated injuries. Ninety-four cases were treated conservatively and 29 cases surgically. The results of the treatment were evaluated by the J.O.A.score.
The results of cases without any nerve injuries were judged as excellent (mean score of conservative cases: 92.3 points, surgical cases: 97.1 poinys). Cases with nerve injuries had poor results (mean score of the conservative cases: 80.3 points, surgical cases: 85.7 points).
An association between scapular fractures and fractures of the ribs is common. In those cases, a pneumothorax may not develop immediately after a traumatic episide, but it may occur after a few days. An acromioclavicular dislocation is apt to be associated with a fracture of the coracoid process, in which case, surgical treatment is indicated. A displaced fracture of the scapular neck associated with a clavicular fracture on the same side is unstable, in which case, surgical treatment is indicated. A rotator cuff tear is apt to be associated with a fracture of the scapular body or but it is often overlooked, Associated nerve injuries have a great inflvence on the results. It is important to examine an associated nerve imjury and to start rehabilitation as soon as possible. neck, very
