Fractures of the scapula. An analysis of forty cases and a review of the literature.

In forty patients treated at The University of Texas Medical Branch Hospitals for fifty-two fractures of forty-one scapulae from 1961 through 1973, most of the fractures were the result of vehicular accidents. The thirty-eight fractures involving only the body, neck, or spine of thirty scapulae (without involvement of the acromion, glenoid, or coracoid process) were successfully treated with a sling and early active motion. Three other fractures involving body were associated with three fractures involving the glenoid. The eleven fractures of the acromiom, glenoid, or coracoid process resulted in loss of motion in ten of the eleven shoulders. For fractures of this type we now recommend immobilization in 60 degrees of abduction, 25 degrees of flexion, and 25 degrees of external rotation, with early active abduction exercises. Open reduction is rarely indicated, only when there is disruption of the glenohumeral joint.