Does ORIF of rare scapular spine fractures sustained after reverse shoulder arthroplasty benefit elderly patients? A case-series appraisal.

PURPOSE: Scapular spine fractures sustained after reverse shoulder arthroplasty (RSA) are debilitating for elderly patients with osteoporosis. We examined the 1-year postoperative outcomes of open reduction and internal fixation (ORIF) in a small case-series, and hypothesised that patients undergoing surgical treatment for post-RSA scapular spine fractures would improve in function and pain.

METHODS

Five consecutive RSA patients within our shoulder arthroplasty register who sustained a scapular spine fracture underwent ORIF using a double plating technique. Standard radiographs and clinical/patient-rated assessments of Constant-Murley (CS), Shoulder Pain And Disability Index (SPADI), Subjective Shoulder Value (SSV) and visual analogue scale (VAS) pain were made up to 12months post-ORIF. Patients were also asked to rate their satisfaction since the surgery. Post-ORIF complications were documented. All post-RSA data were used as a baseline measure for comparison with post-fracture outcomes.

RESULTS

Mean CS, SPADI and SSV scores as well as pain were similar to pre-fracture scores. All patients improved in function and pain, and would undergo the same procedure again. Individual cases of iatrogenic pneumothorax and screw loosening were reported.

CONCLUSIONS

ORIF is a viable option with adequate improvements in function and pain for elderly patients with debilitating scapular spine fractures after RSA.