Operative Management of Scapular Fractures

Assessment of Operative Management of Scapular Fractures in Level 1 Trauma Center

Assessment of functional outcome of operative management of scapular fractures through Arabic version DASH score

Study Overview

• Status: Not yet recruiting
• Conditions: Scapular Fracture
• Intervention / Treatment: Procedure: ORIF

Detailed Description

Scapular fractures are rare, accounting less than1% all fractures. 3-5%all fractures of shoulder girdle, however very serious because 80-90% due to high energy trauma such as Motor car accidents or Fall from height. It can be associated with life-threatening injuries such as thoraco-scapular dissociation and vascular injury as subclavian and axillary vessels and brachial plexus injuries.So morbidity and mortality reports are relatively high.It can be diagnosed by X ray and computed tomography scan (CT scan) that play important role to discover scapular fractures and associated injuries ,and to guide clinical decision such as approaches and other surgical interventions.Most of scapular fractures are managed conservatively by Immbolization in sling .literature stated that conservative management of scapular body fractures and scapular neck fractures displaced less than 10 mm have satisfactory outcome and operative management suitable for displaced glenoid fossa fractures and scapular neck fractures more than 10 mm and associated with better functional outcome.Others stated that conservative management with highly displaced scapular body and neck fractures are associated with satisfactory long -term functional outcome with minor loss of motion and strength.

So standard treatment of scapular fracture is still controversial and there is no clear guidelines about management of scapular fractures.

In Investigators hypothesis, Operative management of scapular fractures is better choice due to better functional outcome, early rehabilitation ,high union rate and less complications. Investigators will try to answer this question ''What is the effect of operative management of scapular fractures on functional outcome?''

• Study Type: Observational
• Enrollment (Estimated): 20

Contacts and Locations

• Study Contact: Name: Ahmed Elbadry Mahmoud, Resident; Phone Number: +201551176565; Email: ahmedelbadry@med.aun.edu.eg
• Study Contact Backup: Name: Mahmoud Badran, Ass prof; Phone Number: +201000341878; Email: mahmoud.badran@aun.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Any patients who meets the inclusion criteria and agrees to be involved in our study will do:

1. Preoperative assessment:

   1. Examination : Neurological and Vascular examination

   2. Imaging:

      • Plain X- ray (True AP - Scapula Y view ) and Plain X-ray (True AP )of contralateral side Measurement of Glenopolar angle (GPA)
      • CT scan

2. Intra-operative assessment:

   a. Selection of approach. b.Postion C.Type of osteosynthesis d. Blood loss e. Radiation exposure.

Description

Inclusion Criteria:

• 1.All patient presented with scapular fractures more than 18 years old involving body, neck and glenoid 2.Intraarticular glenoid fractures with step-off >4 mm 3.>20% of the joint is involved and Fragment large enough to be hold by lag screw.

Exclusion Criteria:

1- Low demanded patients:Age >65 yrs . 2.Scapular fractures of acromion and coracoid process and Osteoporotic fractures .

3.Scapular fractures associated with brain injuries cervical spine injuries and brachial plexus injuries.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of functional outcome	Arabic version DASH score	6 week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of motion	Goniometer	Six months
Strength of shoulder muscle	Handheld dynamometer	Six months
Union rate	X ray-CT	Six months

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Principal Investigator: Ahmed Elbadry Mahmoud, Resident, Assiut University; Study Director: Aly Mohamadean, Prof Dr, Assiut University; Study Director: Mahmoud Badran, Ass.prof, Assiut University

Publications and helpful links

General Publications

• Ideberg R, Grevsten S, Larsson S. Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand. 1995 Oct;66(5):395-7. doi: 10.3109/17453679508995571.
• Voleti PB, Namdari S, Mehta S. Fractures of the scapula. Adv Orthop. 2012;2012:903850. doi: 10.1155/2012/903850. Epub 2012 Nov 20.
• McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980 Oct;20(10):880-3. doi: 10.1097/00005373-198010000-00011.
• 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. doi: 10.2106/00004623-200401000-00002.
• Brown CV, Velmahos G, Wang D, Kennedy S, Demetriades D, Rhee P. Association of scapular fractures and blunt thoracic aortic injury: fact or fiction? Am Surg. 2005 Jan;71(1):54-7.
• Lantry JM, Roberts CS, Giannoudis PV. Operative treatment of scapular fractures: a systematic review. Injury. 2008 Mar;39(3):271-83. doi: 10.1016/j.injury.2007.06.018. Epub 2007 Oct 4.
• Kannan S, Singh HP, Pandey R. A systematic review of management of scapular fractures. Acta Orthop Belg. 2018 Dec;84(4):497-508.
• Mayo KA, Benirschke SK, Mast JW. Displaced fractures of the glenoid fossa. Results of open reduction and internal fixation. Clin Orthop Relat Res. 1998 Feb;(347):122-30.

Study record dates

Study Major Dates

• Study Start (Estimated): April 5, 2024
• Primary Completion (Estimated): January 1, 2025
• Study Completion (Estimated): March 1, 2025

Study Registration Dates

• First Submitted: July 19, 2023
• First Submitted That Met QC Criteria: August 5, 2023
• First Posted (Actual): August 8, 2023

Study Record Updates

• Last Update Posted (Actual): March 26, 2024
• Last Update Submitted That Met QC Criteria: March 23, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Fractures, Bone
• Other Study ID Numbers: Scapular fractures

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No