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Fractures of the scapula surgical neck: outcome after conservative treatment in 13 cases.

BACKGROUND
Conservative treatment of fractures of the scapular neck does not uniformly lead to a success. The purpose of this retrospective study was to analyze the occurrence of glenoid displacement in conservatively treated patients with a scapular neck fracture without concomitant shoulder girdle injury in relation with the clinical outcome.


METHODS
Between 1991 and 2001, 177 patients with a fracture of the scapula were treated in two Dutch clinics. Twenty-four patients sustained a scapular neck fracture, who all, with the exception of one, were treated non-operatively. At follow-up, 13 patients had a functional evaluation and were assessed clinically at an average of 5.5 years after the injury.


RESULTS
All fractures healed uneventfully. At final radiographic evaluation, four patients were found with significant translational displacement of fracture fragments (>1 cm); however, no angular displacement of the glenoid was found (no GPA < 20 degrees ). The functional outcome of the 13 patients was excellent (Constant score: 90). No correlation was found between functional outcome and malunion. There was no significant difference between the SF-36 scores in the follow-up group and the scores for age-matched controls in the general population.


CONCLUSIONS
Non-operative treatment of a surgical neck fracture of the scapula in absence of an ipsilateral shoulder injury and associated permanent neurological impairment leads to a good to excellent functional outcome, with or without significant translational displacement.