Scapula fractures Flashcards
What is the origin of the biceps brachii muscle?
The supraglenoid tuberosity
What is the origin of the acromial head of the deltoideus muscle?
Acromium
What nerves are closely associated with the scapula?
Suprascapular (wraps distally around the scapular spine deep the acromium), axillary (caudal scapulohumeral joint)
What occurs with damage to the suprascapular nerve?
Infraspinatous and supraspinatous atrophy
What are the classification systems used for scapular fracture?
Traditional:
1 - body and spine
2 - neck
3 - glenoid
Cook et al:
1. Extraarticular stable
2. Extraarticular unstable
3. Intraarticular
Which scapular fractures should be repaired?
Extraarticular unstable and intraarticular
What are common extraarticular unstable fractures of the scapula?
Scapula neck, acromium, unstable overriding body fractures
Where is bone depth greatest in the scapula spine?
Cranially it is deepest distally, and caudally it is deepest proximally
How can scapula body fractures be repaired?
Interfragmentary wire, plating
How can acromial fractures be repaired?
K-wires and figure of 8, interfragmentary wiring
How can scapula neck fractures be repaired?
Cross-pinning (normal or divergent), plating
How can supraglenoid tuberosity or glenoid fractures be repaired?
Supraglenoid tuberosity: K-wires and tension band.
Glenoid T-Y: Lag screw should be placed cranial-caudal to stabilize articular component, followed by plating of the neck.
Highly comminuted: consider glenoid excision
How can scapula luxation be repaired?
Wiring of the scapula to the 5th, 6th, or 7th rib. Augmentation with Velpeau sling. Prognosis is excellent.
Can ununited accessory ossification center of the caudal glenoid result in lameness?
Yes, has been reported if unstable. Typically resolves with removal.
