Clinical and functional outcomes of open reduction and internal fixation for scapular fractures using the modified Judet approach.

OBJECTIVE

Displaced scapular fractures are uncommon injuries, and the optimal surgical approach remains controversial. Muscle-preserving techniques may improve post-operative shoulder function by minimizing soft-tissue damage. The purpose of the study was to evaluate the clinical and functional outcomes of open reduction and internal fixation (ORIF) using a muscle-preserving modified Judet approach in displaced scapular fractures and to assess the effect of surgical timing on post-operative shoulder function.

METHODS

This retrospective study included 12 adult patients who underwent ORIF for displaced scapular fractures between 2015 and 2024 with a minimum follow-up of 12 months. Fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association system and treated using the modified Judet approach. Functional outcomes were evaluated using the Constant-Murley, Disabilities of the Arm, Shoulder, and Hand (DASH), and University of California, Los Angeles (UCLA) scores, and shoulder range of motion was compared with the contralateral side.

RESULTS

Mean patient age was 35.3±15.0 years, and mean follow-up was 41.6±37.5 months. Fracture union was achieved in all patients at a mean of 7.5±1.7 weeks. No infections, neurovascular injuries, malunion, or infraspinatus atrophy occurred. Final shoulder motion reached 97% forward flexion, 89% abduction, 93% external rotation, and 90.9% internal rotation compared with the contralateral side. Mean constant, DASH, and UCLA scores were 84.0±8.6, 6.1±8.8, and 31.9±3.4, respectively. All patients returned to work at a mean of 4.7±2.3 months.

CONCLUSION

ORIF using a muscle-preserving modified Judet approach provides reliable union, low complication rates, and satisfactory functional recovery in displaced scapular fractures.