Surgical Treatment of Concomitant Scapular Spine Pseudoarthrosis and Rotator Cuff Impingement: A Case Report
Abstract
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.
2. Silberberg Muino JM, Fulvi AN, Gimenez M. Non-union of Scapular Spine Fracture Case-Report: A Cause of Classical Subacromial Impingement Syndrome. Int J Orthop. 2017;4(6):486-8.
3. Robinson CM, Court-Brown CM. Non-union of scapula spine fracture treated by bone graft and plate fixation. Injury. 1993;24(6):428-9. doi: 10.1016/0020-1383(93)90115-m. [PubMed: 8406756].
4. Ada JR, Miller ME. Scapular fractures. Analysis of 113 cases. Clin Orthop Relat Res. 1991;(269): 174-80. [PubMed: 1864036].
5. Tadros AM, Lunsjo K, Czechowski J, Abu-Zidan FM. Causes of delayed diagnosis of scapular fractures. Injury. 2008;39(3): 314-8. doi: 10.1016/j.injury.2007.10.014. [PubMed: 18243201].
6. Goss TP. The scapula: Coracoid, acromial, and avulsion fractures. Am J Orthop (Belle Mead NJ). 1996;25(2):106-15. [PubMed: 8640380].
7. Gosens T, Speigner B, Minekus J. Fracture of the scapular body: Functional outcome after conservative treatment. J Shoulder Elbow Surg. 2009;18(3):443-8. doi: 10.1016/j.jse.2009.01.030. [PubMed: 19393934].
8. Copuroglu C, Tan L, Copuroglu E, Ciftdemir M, Ozcan M. Pseudo-arthrosis of the spine of the scapula: A case report with a delayed diagnosis. Strategies Trauma Limb Reconstr. 2014;9(3):173-7. doi: 10.1007/s11751-014-0210-2. [PubMed: 25540121]. [PubMed Central: PMC4278966].
9. Bohm P. Pseudarthrosis of the spine of the scapula-case report of a minimally invasive osteosynthesis technique. Acta Orthop Scand. 1998;69(6):645-7. doi: 10.3109/17453679808999274. [PubMed: 9930116].
10. Kibler WB. The scapula in rotator cuff disease. Med Sport Sci. 2012;57:27-40 .doi: 10.1159/000328877. [PubMed: 21986043].
11. As-Sultany M, Tambe A, Clark DI. Nonunion of a scapular spine fracture: Case report and management with open reduction, internal fixation, and bone graft. Int J Shoulder Surg. 2008;2(3):64-7. doi: 10.4103/0973-6042.42202. [PubMed: 20300318]. [PubMed Central: PMC2840823].
Files | ||
Issue | Vol 7, No 2 (2021) | |
Section | Case Report | |
DOI | https://doi.org/10.18502/jost.v7i2.7006 | |
Keywords | ||
Pseudoarthrosis; Scapula; Rotator Cuff |
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