Management of comminuted scapular fracture by open reduction and internal fixation: A case report.

INTRODUCTION

Scapular fracture is rare fracture as it comprises of only 3 % to 5 % of total shoulder fractures also in that, comminuted type is most uncommon type. High velocity force and direct blow are the most common cause of scapular fracture. We report a case of 60 years male with comminuted scapular fracture following physical assault by stick over back.

CASE PRESENTATION: The case study presents a sixty years old male who sustained comminuted scapular fracture following physical assault by stick in the back. The patient presented to Emergency Department with complains of pain and swelling over his left shoulder region. Diagnostic workups including blood test and imaging (X-ray and CT scan) was done to confirm diagnosis revealing the evidence of comminuted scapular fracture on X-ray. The fracture was managed by Open Reduction and Internal Fixation.

DISCUSSION: Scapular fracture accounts for just 1 % of total body fracture. Scapular fractures are rare and typically result from high-energy trauma; this case involved an isolated 14B2 type due to physical assault. Imaging confirmed a closed, comminuted, unstable scapular blade fracture. Surgical management (ORIF) was indicated due to fracture comminution, instability, and absence of comorbidities. At 3-month follow-up, the patient showed excellent functional recovery, highlighting the benefit of surgery in such cases.

CONCLUSION

Comminuted scapular fracture are the most uncommon type of fracture. The surgical management is required depending upon the severity of the scapular fractures as in comminuted type. Comminuted, unstable nature of fracture of scapular blade need to be treated surgically by ORIF.