Abstract
Scapula fractures after reverse shoulder arthroplasty (RSA) may occur in 0.9–10 % of patients. Osteoporosis is a risk factor, so these patients should be counseled on the risk of fracture and treated appropriately. While preoperative acromial insufficiency does not affect outcomes, the clinical outcomes in postoperative fracture patients has been found to be inferior to control patients. A high clinical suspicion is necessary if a patient presents with pain over the scapula or acromion. A computed tomography scan may be necessary to make the diagnosis since plain radiographs are not reliable. The surgeon can improve the detection of fractures on sequential plain radiographs by observing a decreasing distance between the acromion and greater tuberosity (AT) as well as an increasing acromial tilt angle between the scapular spine and acromial body. Once diagnosed, the patient should be immobilized for 6 weeks and then gradually progressed to activities as tolerated. Acromial base or scapular spine fractures may increase the risk of instability and need for revision surgery. Fracture healing has not been found to affect outcome, and with a high complication rate of surgery, surgical fixation of the fractures is not recommended.
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Otto, R.J., Teusink, M.J. (2016). Reverse Shoulder Arthroplasty in the Setting of Scapula Fractures. In: Frankle, M., Marberry, S., Pupello, D. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-20840-4_17
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DOI: https://doi.org/10.1007/978-3-319-20840-4_17
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