Scapular Fractures After Reverse Shoulder Arthroplasty

Joseph W. Galvin, Josef K. Eichinger, Xinning Li, Stephen A. Parada

Research output: Contribution to journalArticlepeer-review

Abstract

With the increased use of reverse shoulder arthroplasty, the complication of postoperative scapular fracture is increasingly recognized. The incidence is variable and dependent on a combination of factors including patient age, sex, bone mineral density, diagnosis of inflammatory arthritis, acromial thickness, and implant-related factors. Acromial stress reactions are a clinical diagnosis based on a history and physical examination. These are treated successfully with 4 to 6 weeks of immobilization. Acromial stress fractures are visible on imaging studies and are classified based on anatomic location by the classification systems of Crosby and Levy. In approximately 20% of fractures, a CT scan is necessary to make the diagnosis. Treatment is typically nonsurgical that leads to a high rate of nonunion or symptomatic malunion. Scapular spine fractures (type III) can be treated with either nonsurgical or surgical management; however, obtaining fracture union is challenging, and the outcomes are typically inferior to that of type I and II fractures. Although the nonsurgical and surgical treatment of acromial stress fractures improves the clinical outcomes from the patient's preoperative state, the outcomes of a control group undergoing reverse shoulder arthroplasty without fracture are better. The exception to this is oftentimes the displaced and angulated type III fracture.

Original languageEnglish (US)
Pages (from-to)e517-e527
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume30
Issue number5
DOIs
StatePublished - Mar 1 2022

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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