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Scapular fractures

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Fall from motorbike onto shoulder.

Patient Data

Age: 45 years
Gender: Male

Right Shoulder radiographs

x-ray

Fractures lines are present from the axillary border of the scapula along the infraspinatus subscapular fossa and in the mid portion of the right clavicle.  

CT Right Shoulder

ct

Comminuted fractures through the body of the right clavicle. Longitudinal comminuted fractures from the lateral to the superior border of the scapula as well as a longitudinal infraspinal fracture from the medial to the lateral border. The coracoid process, the glenoid, and the acromion are preserved. No intra-articular involvement.

Conclusion: Comminuted fractures within the right scapula and clavicle.

Case Discussion

Direct trauma to the shoulder region, as in this case, is one of the major cause of scapular fractures. They usually are associated with other injuries:

  • clavicle fracture (as in this case)
  • rib fracture
  • sternal fracture
  • spinal fracture
  • pneumothorax and/or pulmonary contusion
  • brachial plexus injury

This case has no involvement of the glenoid, acromion, coracoid process, or humeral head. 

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