Epidemiology and current treatment of scapula fractures at a level-1 trauma center

Abstract Background Scapula fractures are rare injuries often associated with complex lesions of the shoulder girdle and severe thoracic trauma. The decision between surgical and conservative treatment is a frequently discussed point and the reality of care differs significantly from theoretical recommendations. Objectives The aim of this study was the epidemiological analysis of scapula fractures at a level‑1 trauma center over a 10-year period and the investigation of the reality of care regarding operative and conservative treatment in relation to criteria published by Cole et al. [14–16] about treatment recommendations. Materials and methods A retrospective single-center study was conducted of all patients treated for a scapula fracture from 1 January 2009 to 31 December 2019. Epidemiological data, the fracture classification according to Euler and Rüedi, concomitant injuries, Injury Severity Score (ISS), accident mechanism, and treatment method were analyzed. Results A total of 175 patients were included in the study. The mean age of the patients was 47 ± 13 years; there was no gender-specific age difference. The most common trauma mechanisms were traffic accidents (60%) followed by falls from a great height (38%). Polytrauma occurred in 58% of cases, with a high association of concomitant thoracic injuries. The mean ISS was 26 ± 18. Overall, 38 patients underwent surgical treatment, although according to the recommendation criteria, surgical treatment would have been indicated in 77 cases. Conclusion Scapula fractures frequently occur in patients with multiple injuries in high-energy trauma. Treatment is predominantly conservative, which is in contrast to the theoretical recommendations for surgical treatment.