Spontaneous scapular spine fracture related to rotator cuff pathology: a report of two cases

Abstract Background The purpose of this study was to identify differences in the morphology of the scapula according to the presence or absence of a rotator cuff tear (RCT). Methods One hundred and three shoulders with and 87 shoulders without RCTs were included in this study. The critical shoulder angle (CSA) and lateral acromion angle in the frontal view and the acromial coverage angle (ACA) and coracoid and scapular spine angle (CSSA) in the lateral view were evaluated using three-dimensional computed tomography. The glenoid anterior tilt, anterior acromial projection angle (AAPA), coracoid process angle, scapular spine angle (SSA) and inferior angle angle (IAA) with respect to the scapular plane were measured in the lateral view. The morphological parameters of the scapula associated with RCT were statistically analysed using a multivariate logistic regression analysis. Results In univariate logistic regression analysis, CSA, ACA, CSSA, AAPA, SSA and IAA were significantly different between shoulders with and without RCTs. In multivariate logistic regression analysis, CSA and IAA were greater in shoulders with RCT and were significantly associated with this condition. Conclusion To the best of our knowledge, this is the first study to focus on the relationship between RCT and the scapular body. RCT cases were characterised by a greater curvature of the scapular body in addition to CSA.

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Atraumatic bilateral scapular spine fracture several months after bilateral reverse total shoulder arthroplasty

Skeletal Radiology ◽

10.1007/s00256-013-1775-4 ◽

2013 ◽

Vol 43 (5) ◽

pp. 699-702 ◽

Cited By ~ 7

Author(s):

Simon Nicolay ◽

Luc De Beuckeleer ◽

Daniël Stoffelen ◽

Filip Vanhoenacker ◽

Marc Pouillon

Keyword(s):

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Reverse Total Shoulder Arthroplasty ◽

Spine Fracture ◽

Scapular Spine ◽

Reverse Total Shoulder

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Reverse Shoulder Arthroplasty, Deltopectoral Approach vs. Anterosuperior Approach: An Overview of the Literature

Frontiers in Surgery ◽

10.3389/fsurg.2021.721054 ◽

2021 ◽

Vol 8 ◽

Author(s):

Paraskevas Georgoulas ◽

Aliki Fiska ◽

Athanasios Ververidis ◽

Georgios I. Drosos ◽

Evanthia Perikleous ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Arthroplasty ◽

Large Scale ◽

Reverse Shoulder Arthroplasty ◽

Clinical Effectiveness ◽

Surgical Approaches ◽

Cuff Tear ◽

Scapular Spine ◽

Deltopectoral Approach

Reverse shoulder arthroplasty (RSA) has become an optimal treatment for numerous orthopedic entities, such as rotator cuff tear arthropathies, pseudoparalysis, fracture sequelae, acute fractures, failed arthroplasties, osteoarthritis, and rheumatoid arthritis, and is linked with relief of topical pain and regaining of functionality. Presently, RSA has been conducted through anterosuperior (AS) or deltopectoral (DP) approach. The aim of the study was to discuss both approaches and to examine broadly their features to render a comparison in terms of clinical effectiveness. An electronic search in PubMed, EMBASE, and Google Scholar databases was performed, using combinations of the following keywords: RSA, DP approach, AS approach, notching, and cuff tear arthropathy. A total of 61 studies were found, and 16 relevant articles were eventually included. Currently published literature has not shown significant diversities in the clinical course due to approach preference; risk of instability seems to be greater in DP approach, while regarding scapular notching and fracture rates the findings were conflicted. In addition, the AS approach has been associated with decreased risk of acromial and scapular spine fractures. In conclusion, both surgical approaches have shown similar clinical outcomes and effectiveness concerning pain and restoring range of motion (ROM) in rotator cuff tear arthropathies. In the future, further investigations based on large-scale well-designed studies are required to address clinical gaps allowing in-depth comparison of both approaches.

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Surgical Treatment of Concomitant Scapular Spine Pseudoarthrosis and Rotator Cuff Impingement: A Case Report

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v7i2.7006 ◽

2021 ◽

Author(s):

Hamid Rabie ◽

Mohammad Reza Guity ◽

Leila Oryadi Zanjani

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Rotator Cuff ◽

Bone Grafting ◽

Case Reports ◽

Rare Condition ◽

Tension Band ◽

Tension Band Wiring ◽

Aggressive Approach ◽

Scapular Spine

Background: Nonunion and pseudoarthrosis formation following scapular spine fracture is a rare condition and is limited only to case reports. Some authors reported its association with rotator cuff impingement. Standard treatment is not defined well as the condition is rare. Case Report: Our patient was a 61-year-old man with painful nonunion in addition to cuff impingement. Surgical treatment by open reduction, internal fixation with reconstruction plate and tension band wiring, along with bone grafting led to fracture union, as well as complete resolution of the rotator cuff tendinopathy. Conclusion: Surgical fixation seems to be the best choice in treating scapular spine pseudoarthrosis. The first attempt should be the best, so we took an aggressive approach by the use of plating, tension band wiring, and bone grafting altogether.

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DISRUPTED SCAPULAR “X” SIGN- A NEW PLAIN FILM FINDING FOR SCAPULAR SPINE FRACTURE

Investigative Radiology ◽

10.1097/00004424-199312000-00076 ◽

1993 ◽

Vol 28 (12) ◽

pp. 1193

Author(s):

D. W. WULFECK ◽

G. WALTON ◽

H. A. THOMAS

Keyword(s):

Plain Film ◽

Spine Fracture ◽

Scapular Spine

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Non-union of Scapular Spine Fracture Case-Report: A Cause of Classical Subacromial Impingement Syndrome

International Journal of Orthopaedics ◽

10.17554/j.issn.2311-5106.2017.04.236 ◽

2017 ◽

Vol 4 (6) ◽

pp. 846-848

Author(s):

Jose Maria Silberberg Mui駉 ◽

◽

Alessandro Nilo Fulvi ◽

Martin Gimenez

Keyword(s):

Case Report ◽

Impingement Syndrome ◽

Spine Fracture ◽

Subacromial Impingement Syndrome ◽

Subacromial Impingement ◽

Non Union ◽

Scapular Spine

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Bilateral acromial stress fractures in a patient with a massive rotator cuff tear

Clinics in Shoulder and Elbow ◽

10.5397/cise.2020.00080 ◽

2020 ◽

Author(s):

Du-Han Kim ◽

Sang-Soo Na ◽

Chung-Sin Baek ◽

Chul-Hyun Cho

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Total Shoulder Arthroplasty ◽

Stress Fractures ◽

Cuff Tear Arthropathy ◽

Posterior Angle ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

Scapular Spine ◽

Reverse Total Shoulder

Stress fractures of the acromion and scapular spine are well-known complications following reverse total shoulder arthroplasty. However, these fractures in patients with massive rotator cuff tear or cuff tear arthropathy are extremely rare, and the pathogenesis, clinical features, diagnosis, and treatment of these fractures are poorly understood. We report a case of bilateral stress fracture of the posterior angle of the acromion in a patient with massive rotator cuff tear and discuss the pathogenesis, clinical manifestation, and treatment with a review of the literature.

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Anatomical Considerations of the Suprascapular Nerve in Rotator Cuff Repairs

Anatomy Research International ◽

10.1155/2014/674179 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

James A. Tom ◽

Addisu Mesfin ◽

Mitesh P. Shah ◽

Mitra Javandel ◽

Dan J. Lee ◽

...

Keyword(s):

Rotator Cuff ◽

Suprascapular Nerve ◽

Arthroscopic Repair ◽

Rotator Cuff Tears ◽

Fat Pad ◽

Anatomic Landmarks ◽

Suprascapular Notch ◽

Lateral Border ◽

Scapular Spine ◽

Slide Technique

Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve’s proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff.

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