OBJECTIVE: The aim of this study is to determine normal glenopolar angle (GPA) values on bone specimens of the scapula and compare them with various radiological views and CT examination. MATERIALS AND METHODS: GPA values were measured on 100 mature, dry, non-paired scapulae, 20 pairs of dry scapulae, 50 AP radiographs of the shoulder, 50 Neer I views, 50 AP chest radiographs and 20 3D CT reconstructions of the scapula. RESULTS: Measurements made on bone specimens of the scapula showed an average GPA value of 42.3°; the mean absolute side-to-side difference was on average 1.6°. The average GPA measured on 50 AP shoulder radiographs was 35.9°, on Neer I views 40.6° and AP chest radiographs 37.1°, with the mean absolute side-to-side difference on average 4.9°; on 3D CT the average GPA was 43.0° and the mean absolute side-to-side difference on average 1.4°. CONCLUSION: GPA values depend on the method of measurement used. Measurements made on 3D CT reconstructions and Neer I views showed almost the same values as those measured on bone specimens. The values measured on AP shoulder views and AP chest radiographs were statistically significantly lower. Side-to-side variability (right and left) measured on 3D CT reconstructions was insignificant, and the obtained values corresponded to the values from bone specimens. Therefore, the best method to measure the GPA is a 3D CT reconstruction and an exact Neer I projection.

• MeSH
• kloubní artrometrie metody   MeSH
• kloubní jamka lopatky anatomie a histologie   diagnostické zobrazování   MeSH
• lidé MeSH
• modely anatomické * MeSH
• mrtvola MeSH
• počítačová rentgenová tomografie metody   MeSH
• referenční standardy MeSH
• reprodukovatelnost výsledků MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: Fractures of the scapular, or glenoid, neck are strongly debated in the relevant literature. Analysis of the respective studies, however, revealed a considerable confusion in terms of definition, terminology and diagnosis. In addition, there are few studies, primarily case reviews, dealing in detail with these fractures. The aim of this article is to present detailed information about fractures of the scapular neck, based on the analysis of our own experience and of the published literature. MATERIAL AND METHODS: Our group of 17 fractures of the scapular neck comprised 14 men and three women, with a mean age of 38 years (range, 24-55). The authors diagnosed four fractures of the anatomical neck, nine fractures of the surgical neck and five trans-spinous fractures of the neck. Of these 17 scapular neck fractures, six fractures were treated non-operatively, and 11 fractures were operated on via the posterior Judet approach. The mean follow-up was 4.9 years (range, 1-11). RESULTS: Fractures in all six non-operatively treated patients healed without complications in the anatomical position and with full function of the shoulder. In 11 operatively treated patients, all fractures of the scapula and clavicle healed within three months. In nine cases the function of the shoulder was subjectively and objectively assessed as normal, and in the remaining two cases as fair. CONCLUSION: The term "scapular, or glenoid, neck" covers three different types of fractures, i.e., fracture of the anatomical neck, fracture of the surgical neck and trans-spinous neck fracture. Fractures of the surgical neck are divided into stable, fractures with rotational instability and fully unstable fractures, depending on the integrity of the coracocacromial and coracoclavicular ligaments. Accurate diagnosis of fractures of the scapular neck requires 3D CT reconstructions. Undisplaced or minimally displaced fractures may be treated non-operatively, markedly displaced fractures constitute an indication for osteosynthesis via the Judet approach.

• MeSH
• dospělí MeSH
• fraktury kostí * klasifikace   diagnóza   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lopatka anatomie a histologie   diagnostické zobrazování   zranění   MeSH
• mladý dospělý MeSH
• rentgendiagnostika MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The authors operated on 22 patients with scapular body fractures, with a mean age of 35 years. The minimal follow-up was 12 months. All patients were treated from the Judet posterior approach. The study included 14 cases of an isolated body fracture, three of scapular body fracture combined with fracture of the scapular neck and five of glenoid fossa fracture. In all 14 cases where a 3D computed tomography (CT) reconstruction was performed prior to operation, intraoperative findings corresponded to this reconstruction. In eight cases without preoperative 3D CT reconstruction, the correct type of fracture was identified in only two cases. We also identified three basic types of fractures of the lateral border of the scapula. The anatomical relationship between the glenoid fossa and scapular body, congruency and stability of the shoulder joint was achieved in all cases. The average constant score was 94.

• MeSH
• dospělí MeSH
• fraktury kostí diagnostické zobrazování   chirurgie   MeSH
• interní fixátory MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lopatka diagnostické zobrazování   zranění   chirurgie   MeSH
• mladý dospělý MeSH
• počítačová rentgenová tomografie MeSH
• pooperační komplikace MeSH
• poranění ramene MeSH
• ramenní kloub patofyziologie   chirurgie   MeSH
• rozsah kloubních pohybů MeSH
• úrazy a nehody MeSH
• vnitřní fixace fraktury metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH