CT diagnostics of scapular fractures

Authors: A. Chochola 1;  M. Tuček 1;  J. Bartoníček 1;  D. Klika 2
Authors‘ workplace: Klinika traumatologie pohybového ústrojí 1. LF UK a ÚVN Praha a Oddělení ortopedie a traumatologie ÚVN, přednosta: Prof. MUDr. J. Bartoníček, DrSc. 1;  Radiodiagnostické oddělení ÚVN, primář MUDr. T. Belšan, CSc. 2
Published in: Rozhl. Chir., 2013, roč. 92, č. 7, s. 385-388.
Category: Original articles

Tato studie vznikla za podpory grantu IGA MZ ČR NT/14092: Diagnostika a operační léčba dislokovaných intraartikulárních zlomenin lopatky.

Věnováno k 85. narozeninám prof. MUDr. Radomíra Čiháka, DrSc.


The aim of the study was to determine the relevance of CT examination in scapular fractures and to standardize it.

Material and methods:
A group of 163 patients with extra-articular fracture of the scapular body and neck was analysed. 3D CT was performed in 85 of them and 31 patients were operated on. This group served as the basis for evaluating the benefits of CT examination for the diagnostics of scapular fractures.

CT scans are very helpful for the evaluation of the glenoid fossa and, where necessary, of the processes of the scapula. They, however, do not allow for a correct determination of the fracture types, those of the scapular body and neck in particular. Three-dimensional CT (3D CT) reconstruction is the only method allowing for the determination of the exact types of scapula fracture. In these reconstructions it is necessary to image the scapula from three standardized views, i.e. from posterior, anterior and lateral aspects, after subtraction of the ribs, the proximal humerus and the clavicle.

All fractures of the scapular body and neck require 3D CT reconstruction.

Key words:
scapula, scapula fractures – radiodiagnostics – CT scans – classification of scapular fractures


1. Ada JR, Miller ME. Scapula fractures. Analysis of 113 cases. Clin Orthop Rel Res 1991;269:174–180.

2. Armitage BM, Wijdicks CA, Tarkin IS, et al. Mapping of scapular fractures with three-dimensional computed tomography. J Bone Joint Surg 2009[Am];91-A:2222–2228.

3. Armstrong CP, van der Spuy J. The fractured scapula: Importance and management based on a series of 62 patients. Injury 1984;15:324–329.

4. Bartoníček J, Cronier P. History of the treatment of scapular fractures. Arch Orthop Trauma Surg 2010;130:83–92.

5. Bartoníček J, Frič V. Scapular body fractures: Results of the operative treatment. Inter Orthop (SICOT) 2011;35:747–753.

6. Cole PA, Gauger EM, Herrera DA, et al. Radiographic follow-up of 84 operatively treated scapula neck and body fractures. Injury 2012;43:327–333.

7. Cole PA, Gauger EM, Schroder LK. Management of scapular fractures. J Am Acad Orthop Surg 2012;20:130–141.

8. Hersovici D, Roberts CS. Scapula fractures: to fix or not to fix? J Orthop Trauma 2006;20:227–229.

9. Lantry JM, Roberts CS, Giannoudis PV. Operative treatment of scapular fractures: A systematic review. Injury 2008;39:271–283.

10. Zlowodski M, Bhandari M, Zelle BA, et al. Treatment of scapula fractures: Systematic review of 520 fractures in 22 case series. J Orthop Trauma 2006;20:230–233.

11. Bartoníček J, Tuček M, Luňáček L. Judetův zadní přístup k lopatce. Acta Chir Orthop Traumatol Čech 2008;75:429–435.

12. Bartoníček J, Frič V, Tuček M. Radiodiagnostika zlomenin lopatky. Rozhl Chir 2009;88:84–88.

13. Bartoníček J, Frič V, Tuček M. Zlomeniny lopatky. Diagnostika-klasifikace-terapie. Ortopedie. 2010;4:151–156.

14. Bartoníček J, Tuček M, Frič V. Operační léčba zlomenin lopatky. Ortopedie. 2010;4:204–210.

15. Tuček M, Bartoníček J. Přidružená poranění u zlomenin lopatky. Rozhl Chir 2010;89:288–292.

16. McAdams TR, Blevins FT, Martin TP, et al. The role of plain films and computed tomography in the evaluation of scapular neck fractures. J Orthop Trauma 2002;16:7–11.

17. Anavian J, Conflicitti JM, Khanna G, et al. A reliable radiographic measurement technique for extra-articular scapular fractures. Clin Orthop Rel Res 2011;469:3371–3378.

18. Chan CM, Chung CT, Lan HHC. Scapular fracture complicating suprascapular neuropathy: The role of computed tomography with 3D reconstruction. J Chin Med Assoc. 2009;72:340–342.

19. Megan J, Patterson JMM, Galatz L, et al. CT evaluation of extra-articular glenoid neck fractures: Does the glenoid medialize or does the scapula lateralize? J Orthop Trauma 2012;26:360–363.

20. Tadros AMA, Lunsjo K, Czechowski J, et al. Usefulness of different imaging modalities in the assessment of scapular fractures caused by blunt trauma. Acta Radiol 2007;48:71–75.

21. Tadros AMA, Lunsjo K, Czechowski J, et al. Causes of delayed diagnosis of scapular fractures. Injury 2008;39:314–318.

22. Zuckerman SL, Song Y, Ombreskey WT. Understanding the concept of medialization in scapula fractures. J Orthop Trauma 2012;26:350–357.

23. Tuček M, Bartoníček J, Novotný P, Voldřich M. Bilateral scapular fractures in adults. Inter Orthop (SICOT) 2013;37:659–665.

Surgery Orthopaedics Trauma surgery
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