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Diagnosis and Treatment of Scapular Fractures in Children and Adolescents: A Critical Analysis Review

. 2022 Feb 15 ; 10 (2) : . [epub] 20220215

Language English Country United States Media electronic

Document type Journal Article, Review

Links

PubMed 35171874
DOI 10.2106/jbjs.rvw.21.00132
PII: 01874474-202202000-00006
Knihovny.cz E-resources

»: Fractures of the growing scapula account for about 0.1% of all pediatric fractures, with the majority occurring at an age of ≥10 years. »: Radiographic diagnosis requires a detailed knowledge of the ossification sequence of the growing scapula. Computed tomography examination is indicated for displaced fractures of the glenoid fossa, the scapular neck, and complex fractures; magnetic resonance imaging should be performed in cases of suspected injury to the physis and with stress fractures, depending on patient age and the potential need for general anesthesia during the scanning process. »: Separation of the base of the coracoid process is often associated with acromioclavicular dislocation. Clavicular fractures rarely occur in combination with injuries to the growing scapula. »: The majority of scapular fractures can be treated nonoperatively. Indications for surgery are displaced intra-articular fractures, scapular neck fractures with a displacement of >2 cm, coracoid base separation associated with acromioclavicular dislocation, and scapulothoracic dissociation. »: Displaced intra-articular fractures of the glenoid fossa should be followed after healing until skeletal maturity. Complications are rare and occur most frequently with scapulothoracic dissociation.

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Bartoníček J, Naňka O. History of diagnostics and treatment of scapular fractures in children and adolescents and its clinical importance. Arch Orthop Trauma Surg. 2021 Feb 4.

Blount WP. Fractures in children. 1st ed. Baltimore: Williams and Wilkins; 1955.

Weber BG, Brunner Ch, Freuler F. Die Frakturbehandlung bei Kindern und Jugendlichen. Berlin: Springer; 1978.

Ogden JA. Skeletal injury in the child. 3rd ed. Springer; 2000.

Webb LX, Mooney JF. Fractures and dislocations about the shoulder. In: Green NE, Swiontkowski MF, editors. Skeletal trauma in children. 3rd ed. Saunders; 2003. p 328-331.

Abzug JM, Waters PM. Clavicle and scapula fractures: Acromioclavicular and sternoclavicular injuries. In: Flynn JM, Skaggs DL, Waters PM, editors. Rockwood and Wilkins’ Fractures in children. 8th ed. Wolters Kluwer; 2015. p 822-827.

Goldstein RY, Chu A, Otsuka NY. Scapular fractures in the adolescent patient: Diagnosis, management, and complications. In: Zuckerman JD, editor. Disorders of the shoulder. Volume 3. 3rd ed. Wolters Kluwer-Lippincott Williams and Wilkins; 2014. p 290-299.

Fabricant PD, Flynn JM. Fractures, dislocations, and acquired problems of the shoulder in children. In: Rockwood CA, Matsen FA, Wirth MA, Lippit SB, Fehringer EV, Sperling JW, editors. Rockwood and Matsen’s the Shoulder. 5th ed. Elsevier; 2017. p 533-540.

Vesalius A. The fabric of the human body: An annotated translation of the 1543 and 1555 editions of De humani corporis fabrica libri septem. Garrison DH, Hast MH, editors. Basel: Karger; 2014.

Cheselden W. Osteographia, or the anatomy of the bones. London; 1733.

Kerkring T. Osteogenia foetuum. Amsterdam; 1670. p 251-253.

Nesbitt R. Human osteogeny explained in two lectures. London: T. Wood; 1736. p 118-120.

Nesbitt R. Osteogenie oder Abhandlung von Erzeugung der Knochen im menschlichen Körper. Altenburg: Druck und Verlag Paul Emmanuel Richters; 1753.

Rambaud A, Renault Ch. Origine et développement des os. Paris: F. Chamerot; 1864.

Ogden JA, Phillips SB. Radiology of postnatal skeletal development. VII. The scapula. Skeletal Radiol. 1983;9(3):157-69.

Cunningham C, Scheuer L, Black S. Developmental juvenile osteology. 2nd edition. Academic Press; 2016. p 270-282.

Kothary S, Rosenberg ZS, Poncinelli LL, Kwong S. Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features. Skeletal Radiol. 2014 Sep;43(9):1281-8.

Kothary P, Rosenberg ZS. Skeletal developmental patterns in the acromial process and distal clavicle as observed by MRI. Skeletal Radiol. 2015 Feb;44(2):207-15.

Winfeld M, Rosenberg ZS, Wang A, Bencardino J. Differentiating os acromiale from normally developing acromial ossification centers using magnetic resonance imaging. Skeletal Radiol. 2015 May;44(5):667-72.

Zember JS, Rosenberg ZS, Kwong S, Kothary SP, Bedoya MA. Normal skeletal maturation and imaging pitfalls in the pediatric shoulder. Radiographics. 2015 Jul-Aug;35(4):1108-22.

South JF. Case of fracture of the coracoid process of the scapula, with partial dislocation of the humerus forwards, &c. Med Chir Trans. 1839;22:100-9.

Bartonícek J, Cronier P. History of the treatment of scapula fractures. Arch Orthop Trauma Surg. 2010 Jan;130(1):83-92.

Callaway T. A dissertation upon dislocations and fractures of the clavicle and shoulder-joint. London: Samuel Highley; 1849.

Sissons WH. Compound fracture of the scapula – recovery. Med Times Gazette. 1860;2:357.

Poland J. Osteomyelitis of the scapula; separation of its coracoid epiphysis; pyemia (Card specimen). Pathol Soc Transact London. 1887;38:261-2.

Bennett EH. Separation of the coracoid epiphysis of the scapula. Trans Royal Acad Med Ireland. 1888;6:408-10.

Bennett EH. Separation of the coracoid epiphysis of the scapula. Dublin J Med Science. 1888;86:97-9.

Poland J. Traumatic separation of the epiphyses. London: Smith and Elder; 1898. p 144-162.

Lucas RC. A case of fracture of the coracoid process uncomplicated with other injury with a study of the lesion. Guys Hosp Rep. 1890;47:45-57.

Braine. Décollement épiphysaire de l_extrémité supérieure de l_humérus avec fractures de l_omoplate: 1° fracture de lafosse sous-épineuse; 2° fracture de la coracoide à sa base chez un enfant de 13 ans. Bull Mémoir Sociét Anat Paris. 1919;386-390.

Richmond CE. Two cases of fracture of the scapula. BMJ. 1880 May 8;692-3.

Bramwell P. Fracture of the neck of the left scapula. BMJ. 1887 Jun 9;70.

Wagner RC. Fracture of both scapulae in an infant. University Med Magazine. 1893-1894;6:470-1.

Lorthioir P. Fractures du corps de l’omoplate. Archiv Franco-Belges Chir. 1927;30:888-9.

Pilling L, Steinert V, Hörmann D. Skapulafrakturen im Kindesalter. Zentralbl Chir. 1980;105(19):1302-4.

Protass JJ, Stampfli FV, Osmer JC. Coracoid process fracture diagnosis in acromioclavicular separation. Radiology. 1975 Jul;116(1):61-4.

Zettas JP, Muchnic PD. Fractures of the coracoid process base in acute acromioclavicular separation. Orthop Rev. 1976;5(11):77-9.

Montgomery SP, Loyd RD. Avulsion fracture of the coracoid epiphysis with acromioclavicular separation. Report of two cases in adolescents and review of the literature. J Bone Joint Surg Am. 1977 Oct;59(7):963-5.

Zilberman Z, Rejovitzky R. Fracture of the coracoid process of the scapula. Injury. 1981 Nov;13(3):203-6.

Heyse-Moore GH, Stoker DJ. Avulsion fractures of the scapula. Skeletal Radiol. 1982;9(1):27-32.

Bernard TN Jr, Brunet ME, Haddad RJ Jr. Fractured coracoid process in acromioclavicular dislocations. Report of four cases and review of the literature. Clin Orthop Relat Res. 1983 May;(175):227-32.

Banerjee AK, Field S. An unusual scapular fracture caused by a water skiing accident. Br J Radiol. 1985 May;58(689):465-7.

Taga I, Yoneda M, Ono K. Epiphyseal separation of the coracoid process associated with acromioclavicular sprain. A case report and review of the literature. Clin Orthop Relat Res. 1986 Jun;(207):138-41.

Starke W. Isolierte Frakturen des Schulterblattes im Kindes- und Jugendalter. Aktuelle Traumatol. 1988 Apr;18(2):73-5.

Martín-Herrero T, Rodríguez-Merchán C, Munuera-Martínez L. Fractures of the coracoid process: presentation of seven cases and review of the literature. J Trauma. 1990 Dec;30(12):1597-9.

Gil JF, Haydar A. Isolated injury of the coracoid process: case report. J Trauma. 1991 Dec;31(12):1696-7.

Ng GPK, Cole WG. Three-dimensional CT reconstruction of the scapula in the management of a child with a displaced intra-articular fracture of the glenoid. Injury. 1994 Dec;25(10):679-80.

Warner JJP, Port J. Stress fracture of the acromion. J Shoulder Elbow Surg. 1994 Jul;3(4):262-5.

Bauer G, Fleischmann W, Dussler E. Displaced scapular fractures: indication and long-term results of open reduction and internal fixation. Arch Orthop Trauma Surg. 1995;114(4):215-9.

Combalía A, Arandes JM, Alemany X, Ramón R. Acromioclavicular dislocation with epiphyseal separation of the coracoid process: report of a case and review of the literature. J Trauma. 1995 May;38(5):812-5.

Eyres KS, Brooks A, Stanley D. Fractures of the coracoid process. J Bone Joint Surg Br. 1995 May;77(3):425-8.

Hart RA, Diamandakis V, el-Khoury G, Buckwalter JA. A stress fracture of the scapular body in a child. Iowa Orthop J. 1995;15:228-32.

Cottalorda J, Allard D, Dutour N, Chavrier Y. Fracture of the coracoid process in an adolescent. Injury. 1996 Jul;27(6):436-7.

Nakae H, Endo S. Traumatic posterior dislocation of the shoulder with fracture of the acromion in a child. Arch Orthop Trauma Surg. 1996;115(3-4):238-9.

Blue JM, Anglen JO, Helikson MA. Fracture of the scapula with intrathoracic penetration. A case report. J Bone Joint Surg Am. 1997 Jul;79(7):1076-8.

Lee SJ, Meinhard BP, Schultz E, Toledano B. Open reduction and internal fixation of a glenoid fossa fracture in a child: a case report and review of the literature. J Orthop Trauma. 1997 Aug;11(6):452-4.

Brindle TJ, Coen M. Scapular avulsion fracture of a high school wrestler. J Orthop Sports Phys Ther. 1998 Jun;27(6):444-7.

Holst AK, Christiansen JV. Epiphyseal separation of the coracoid process without acromioclavicular dislocation. Skeletal Radiol. 1998 Aug;27(8):461-2.

Moon BS, Price CT, Campbell JB. Upper extremity and rib stress fractures in a child. Skeletal Radiol. 1998 Jul;27(7):403-5.

Kaminsky SB, Pierce VD. Nonunion of a scapula body fracture in a high school football player. Am J Orthop. 2002 Aug;31(8):456-7.

Bowen TR, Miller F. Greenstick fracture of the scapula: a cause of scapular winging. J Orthop Trauma. 2006 Feb;20(2):147-9.

Curtis C, Sharma V, Micheli L. Delayed union of a scapular fracture - An unusual cause of persistent shoulder pain. Med Sci Sports Exerc. 2007;39(12):2095-8.

Tryfonidis M, Reynolds J, Ostlere S, Matthews S. Greenstick fracture of the scapular blade; an unusual case of winging of the scapula.. Inj Extra. 2008;39(4):130-3.

Caesar BC, Qureshi AA, Hay SM. Locked and angulated fracture of the scapula blade in a 15-year-old rugby player: a closed manipulation technique for reduction. Eur J Orthop Surg Traumatol. 2009;19:93-5.

DiPaola M, Marchetto P. Coracoid process fracture with acromioclavicular joint separation in an American football player: a case report and literature review. Am J Orthop (Belle Mead NJ). 2009 Jan;38(1):37-9, discussion 40.

Leijnen M, Steenvoorde P, Da Costa A, Adhin S. Isolated apophyseal avulsion of the coracoid process: case report and review of literature. Acta Orthop Belg. 2009 Apr;75(2):262-4.

Burda R, Cibur P, Kitka M. [Subperiostal direct scapular fracture in a child]. Rozhl Chir. 2010 Feb;89(2):146-7. Slovak.

Jettoo P, de Kiewiet G, England S. Base of coracoid process fracture with acromioclavicular dislocation in a child. J Orthop Surg Res. 2010 Oct 18;5:77.

Toro FG, Vaisman A, Villalón IE, Calvo R. Fracture dislocation of the glenoid fossa with open physis: a case report. J Pediatr Orthop. 2010 Jun;30(4):336-8.

Kim MJJ, Rinsky LA, MacKenzie JD. Scapular stress fracture initially masquerading as tumor or infection. Radiol Case Rep. 2015 Nov 6;6(4):510.

Nakama K, Gotoh M, Mitsui Y, Okawa T, Higuchi F, Nagata K. Epiphyseal fracture of the coracoid process occurring at the conjoined tendon origin. Case Rep Orthop. 2011;2011:329745.

Chitre AR, Divecha HM, Hakimi M, Marynissen HAJ. Traumatic isolated coracoid fractures in the adolescent. Case Rep Orthop. 2012;2012:371627.

Szopinski KT, Adamczyk G, Drwiega M. Traumatic detachment of the inferior angle of the scapula in a 5-year-old boy—a sonographic diagnosis. Skeletal Radiol. 2012 May;41(5):615-8.

Pedersen V, Prall WC, Ockert B, Haasters F. Non-operative treatment of a fracture to the coracoid process with acromioclavicular dislocation in an adolescent. Orthop Rev (Pavia). 2014 Aug 8;6(3):5499.

Kose O, Canbora K, Guler F, Kilicaslan OF, May H. Acromioclavicular dislocation associated with coracoid process fracture: Report of two cases and review of the literature. Case Rep Orthop. 2015;2015:858969.

Park KJ, Kim YM, Kim DS, Choi ES, Shon HC, Jeong JJ. Avulsion fracture of the acromial physis in a 14-year-old boy: a case report. Arch Orthop Trauma Surg. 2015 Feb;135(2):223-5.

Archik S, Nanda SN, Tripathi S, Choudhari A, Rajadhyaksha H. An isolated displaced fracture of the coracoid process treated with open reduction and internal fixation - A case report and review of literature. J Orthop Case Rep. 2016 Jan-Mar;6(1):37-9.

Shin SJ, Wang SI, Kim JR. Lung injury caused by greenstick fracture of the scapular body in a 6-year-old boy. Skeletal Radiol. 2016 Apr;45(4):555-8.

Park HY, Jang HJ, Sur YJ. Scapular body fracture and concomitant inferior angle apophyseal separation with intrathoracic displacement: a case report. J Pediatr Orthop B. 2017 Sep;26(5):429-32.

Miller C, Grainger AJ, Phillips RS, Sabouni MY, Kraft JK. Bowing fracture of the inferior angle of the scapula, a difficult diagnosis. Pediatr Radiol. 2018 Jan;48(1):146-9.

Kuhl PJ, Bley T, Veldhoen S. Die isolierte traumatische Avulsionsfraktur der Apophyse des Processus coracoideus als Differenzialdiagnose des Claviculahochstands beim Adoleszenten. Röfo Fortschr Geb Röntgenstr Nuklearmed. 2019 Oct;191(10):946-7.

Wollstein J, Tegtbur U, Meller R, Hanke AA, Berndt T, Krettek C, Weber-Spickschen TS. Isolierte Fraktur des Processus coracoideus bei einem 14-jährigen Wasserballnationalspieler : Fallbeispiel. Unfallchirurg. 2019 Jan;122(1):79-82.

Edgington J, Antonacci CL, Alberta FG. Nonoperative management of a displaced cartilaginous avulsion fracture of the inferior aspect of the scapula. JSES Int. 2020 Apr 4;4(2):280-6.

Bartoníček J, Tuček M, Naňka O. Zlomeniny lopatky [Scapular fractures]. Praha: Maxdorf; 2021. p 373-414.

Shannon SF, Hernandez NM, Sems SA, Larson AN, Milbrandt TA. High-energy pediatric scapula fractures and their associated injuries. J Pediatr Orthop. 2019 Aug;39(7):377-81.

Kalideen JM, Satyapal KS. Fractures of the acromion in tetanus neonatorum [corrected]. Clin Radiol. 1994 Aug;49(8):563-5.

Jacoby J, Nicholls AJ, Clarke NMP, Fairhurst J. Bilateral acromial fractures in a neonate with epileptic encephalopathy. Pediatr Radiol. 2011 Jun;41(6):788-9.

Coote JM, Steward CG, Grier DJ. Bilateral acromial fractures in an infant with malignant osteopetrosis. Clin Radiol. 2000 Jan;55(1):70-2.

Knapik DM, Patel SH, Wetzel RJ, Voos JE. Prevalence and Management of Coracoid Fracture Sustained During Sporting Activities and Time to Return to Sport: A Systematic Review. Am J Sports Med. 2018 Mar;46(3):753-8.

Chauvin NA, Jaimes C, Laor T, Jaramillo D. Magnetic resonance imaging of the pediatric shoulder [xi.]. Magn Reson Imaging Clin N Am. 2012 May;20(2):327-47.

Roedl JB, Morrison WB, Ciccotti MG, Zoga AC. Acromial apophysiolysis: superior shoulder pain and acromial nonfusion in the young throwing athlete. Radiology. 2015 Jan;274(1):201-9.

Alaia EF, Rosenberg ZS, Rossi I, Zember J, Roedl JB, Pinkney L, Steinbach LS. Growth plate injury at the base of the coracoid: MRI features. Skeletal Radiol. 2017 Nov;46(11):1507-12.

Currarino G, Prescott P. Fractures of the acromion in young children and a description of a variant in acromial ossification which may mimic a fracture. Pediatr Radiol. 1994;24(4):251-5.

Bartoníček J. Scapular fractures. In: Tornetta P, Ricci WM, Ostrum RF, McKee MD, McQueen MM, Court-Brown CH, editors. Rockwood and Green’s Fractures in Adults. 9th ed. Wolters Kluwer; 2020. p 976-1008.

An HS, Vonderbrink JP, Ebraheim NA, Shiple F, Jackson WT. Open scapulothoracic dissociation with intact neurovascular status in a child. J Orthop Trauma. 1988;2(1):36-8.

Morris CS, Lloyd T. Case report 642: Traumatic scapulothoracic dissociation in a child. Skeletal Radiol. 1990;19(8):607-8.

Oni OOA, Hoskinson J, McPherson S. Closed traumatic scapulothoracic dissociation. Injury. 1992;23(2):138-9.

Lange RH, Noel SH. Traumatic lateral scapular displacement: an expanded spectrum of associated neurovascular injury. J Orthop Trauma. 1993;7(4):361-6.

Zelle BA, Pape HC, Gerich TG, Garapati R, Ceylan B, Krettek C. Functional outcome following scapulothoracic dissociation. J Bone Joint Surg Am. 2004 Jan;86(1):2-8.

Wright JG. Revised grades of recommendation for summaries or reviews of orthopaedic surgical studies. J Bone Joint Surg Am. 2006 May;88(5):1161-2.

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