Clinical Outcomes and Shoulder Kinematics for the “Gray Zone” Extra-Articular Scapula Fracture in 5 Patients

Details

• Personal Author:
  Armstrong AD ; Karduna AR ; Lehman EB ; Maenza C ; Myers A ; Sainburg RL ; Sharma J
• Description:
  Aims: There is a subset of scapula fractures, which can be considered in the "gray zone," where treatment guidelines are not clear-cut, based on published literature. Our paper presents the outcomes of five such scapula fractures treated non-operatively. Methods: Adult patients who had been treated non-operatively at our institution for an isolated scapula fracture from 2003-2012 were found using Current Procedural Terminology (CPT) codes. Based on injury imaging, these five patients had scapula fractures in the "gray zone." Subjects completed questionnaires [Simple Shoulder Test (SST), PROMIS Global Health Scale vs 1.1, PROMIS SF vs 1.0 Physical Function 12a, and the American Shoulder and Elbow Surgeons Score (ASES)] and physical exams were performed to assess range of motion and strength. Glenohumeral kinematics were obtained via motion analysis using the Trackstar 6 Degree of Freedom (DOF) motion tracking system by Northern Digital Incorporated. Results: All subjects were right hand dominant. 3/5 fractures involved left, non-dominant, scapulae. Motion analysis demonstrated similar recruitment of the scapula during the glenohumeral rhythm for the fractured shoulders compared with the same arm of age matched control subjects. No significant differences occurred in either range of motion (ROM) or scapula-humeral coordination when comparing uninjured scapulae to the same arm of age matched control subjects. Conclusions: All subjects' demonstrated acceptable clinical outcomes when treated non-operatively. Minor differences were seen in subjective surveys. However, the kinematic analysis showed no differences in measured scapula-humeral rhythm or range of motion. It is proposed that immediate controlled range of motion and rehabilitation be considered in these patients and could be the focus of a larger prospective study. [Description provided by NIOSH]
• Subjects:
  Biomechanical Phenomena Musculoskeletal Diseases Musculoskeletal System Occupational Health Safety
• Keywords:
  Author Keywords: Scapula Fracture Biomechanics Bone Disorders Clinical Techniques Extra-articular Scapula Fracture Glenohumeral Rhythm Medical Treatment Motion Analysis MSD Musculoskeletal Disorders Scapulohumeral Rhythm Shoulder Kinematics Skeletal Disorders Upper Extremities

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• ISSN:
  2643-2692
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Oregon ; OSHA Region 10 ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  3
• Issue:
  1
• NIOSHTIC Number:
  nn:20062835
• Citation:
  Int J Orthop 2020 Spring; 3(1):1014
• Contact Point Address:
  April Armstrong, Department of Orthopaedics and Rehabilitation, Penn State Health Hershey and Penn State College of Medicine, Hershey, PA, USA
• Email:
  aarmstrong@pennstatehealth.psu.edu
• Federal Fiscal Year:
  2020
• Performing Organization:
  MCP Hahnemann University, Philadelphia, Pennsylvania
• Peer Reviewed:
  False
• Start Date:
  20000801
• Source Full Name:
  International Journal of Orthopedics
• End Date:
  20020731
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:aa7a904f5fad7d714014ac6e26f4a091439bfaf802d7e724b37d13a4995dd24543d0fed2c4b9b16f88d5aeb67ca79dcde5c98d7caaaa60a011fe6ccbaed2dc58
• Download URL:
  https://stacks.cdc.gov/view/cdc/226012/cdc_226012_DS1.pdf
• File Type:
  [PDF - 1.73 MB ]