Comminuted fracture of body of scapula with fracture infra-glenoid neck, fixation with conventional 3.5 reconstructive locking plate and locking compressive T plate, 2 years follow up: A Case Report and Review.

Incident of scapula fracture is 1% of all fractures and 3-5% in fractures of shoulder girdle. Scapula fracture occurs in high energy trauma in young and low energy fractures in elderly patient.95% scapula fractures are managed conservatively and there are high chances of asymptomatic malunion, rotator cuff dysfunction, impingement and scapulothoracic dyskinesia. Conservative management in scapula fracture with floating shoulder, Superior Shoulder Suspensory Complex (SSSC) injury & multiple rib fractures, delay in rehabilitation and compromises the functional result. There are no specific guidelines found regarding the surgical management of scapula fracture associated with clavicle fracture (Floating shoulder) and surgical treatment in these cases remains controversial. However, the open reduction and internal fixation (ORIF) of scapula fractures in such cases, the results are superior compared to conservative management in view of pain, stiffness and functional outcome with minimal complications. Scapula fracture fixation surgery is considered rare and techniqully demanding in South Asian country like India and hence, we are presenting a case of young patient with poly trauma with ipsilateral significantly displaced clavicle midshaft fracture, extra articular comminuted displaced scapular body and infra glenoid fracture with multiple rib fractures. Considering his young age ,job and to reduce his morbidity due to pain and disability, we offered him ORIF of scapula body and glenoid neck with conventional 3.5 reconstructive plate & locking compressive plate (LCP) and ‘anatomically precontoured LCP’ for clavicle midshaft comminuted fracture. Within one month of operation, patient recovered all the function of shoulder with good power and resumed his carpentry work with no complications. Uniqueness of this case is we have used conventional 3.5 reconstructive locking plate as the classical Boomerang plate was not available and we got optimum functional result.