Abstract：
BACKGROUND: The majority of scapula fractures have historically been treated non-operatively. The current literature describing patient outcomes following scapula fractures is limited. Our objective was to determine differences in outcomes between operatively and non-operatively treated scapular fractures. The goal of our study was to provide an updated and comprehensive systematic review for scapula body, neck, and glenoid fractures focusing on several outcomes including union rate, return to work, pain, shoulder active range of motion, strength, functional scores, and any recorded complications.
METHODS: The PRISMA methodology was followed for this systematic review. Articles were obtained from the PubMed/Medline database using the following search terms: scapula body OR scapula neck OR intra-articular glenoid AND fracture. Additional articles were obtained by searching the bibliographies of included references. Studies were included if they contained clinical data on one or more of our study objectives and contained participants with a scapular body, neck, and/or glenoid fracture who were at least 16 years old. A total of 35 papers, with 822 total cases were included. Studies chosen were assessed for level of evidence and reviewed for data pertaining to the current study objectives. All cases of scapula fractures found throughout the literature were analyzed for outcome data. Outcomes studied included union rate, return to work, pain, shoulder active range of motion, strength, functional scores, and recorded complications.
RESULTS: The overwhelming majority of scapula fractures go on to union. The majority of patients will eventually return to work. Persistent post-injury pain is unfortunately common. Shoulder range of motion and strength are decreased when compared to the contralateral shoulder. Non-operative glenoid fractures have the lowest reported functional scores. Malunion, need for additional surgeries, and post-traumatic arthritis were the most common complications.
CONCLUSIONS: When treating scapula fractures, orthopedic surgeons must consider the specific fracture pattern, as well as patient specific goals. Risks and benefits of both operative and non-operative management should be discussed with the patient including the exceptionally low non-union rate regardless of treatment option and that persistent pain following injury is unfortunately common.
METHODS: The PRISMA methodology was followed for this systematic review. Articles were obtained from the PubMed/Medline database using the following search terms: scapula body OR scapula neck OR intra-articular glenoid AND fracture. Additional articles were obtained by searching the bibliographies of included references. Studies were included if they contained clinical data on one or more of our study objectives and contained participants with a scapular body, neck, and/or glenoid fracture who were at least 16 years old. A total of 35 papers, with 822 total cases were included. Studies chosen were assessed for level of evidence and reviewed for data pertaining to the current study objectives. All cases of scapula fractures found throughout the literature were analyzed for outcome data. Outcomes studied included union rate, return to work, pain, shoulder active range of motion, strength, functional scores, and recorded complications.
RESULTS: The overwhelming majority of scapula fractures go on to union. The majority of patients will eventually return to work. Persistent post-injury pain is unfortunately common. Shoulder range of motion and strength are decreased when compared to the contralateral shoulder. Non-operative glenoid fractures have the lowest reported functional scores. Malunion, need for additional surgeries, and post-traumatic arthritis were the most common complications.
CONCLUSIONS: When treating scapula fractures, orthopedic surgeons must consider the specific fracture pattern, as well as patient specific goals. Risks and benefits of both operative and non-operative management should be discussed with the patient including the exceptionally low non-union rate regardless of treatment option and that persistent pain following injury is unfortunately common.
摘要：
背景：历史上大多数肩胛骨骨折都是非手术治疗。目前描述肩胛骨骨折后患者预后的文献有限。我们的目的是确定手术和非手术治疗的肩胛骨骨折之间结果的差异。我们的研究目的是提供一个更新和全面的系统评价肩胛骨体，脖子,关节盂骨折关注几个结果，包括愈合率，重返工作岗位,疼痛,肩部活动范围，力量,功能分数，和任何记录的并发症。
方法：本系统综述遵循PRISMA方法。文章来自PubMed/Medline数据库，使用以下搜索词：肩胛骨体或肩胛骨颈或关节内关节盂和骨折。通过搜索所包括的参考文献的参考书目获得了其他文章。如果研究包含有关我们的一个或多个研究目标的临床数据，并且包含具有肩胛骨体的参与者，脖子,和/或至少16岁的关节盂骨折。共35篇论文，共包括822例。对选择的研究进行证据水平评估，并对与当前研究目标有关的数据进行审查。分析了所有文献中发现的肩胛骨骨折病例的结果数据。研究结果包括工会率，重返工作岗位,疼痛,肩部活动范围，力量,功能分数，并记录并发症。
结果：绝大多数肩胛骨骨折继续愈合。大多数患者最终将重返工作岗位。不幸的是，持续的伤后疼痛很常见。与对侧肩膀相比，肩膀的运动范围和力量减少。非手术性关节盂骨折的功能评分最低。Malunion,需要额外的手术，创伤后关节炎是最常见的并发症。
结论：治疗肩胛骨骨折时，骨科医生必须考虑具体的骨折模式，患者的具体目标。应与患者讨论手术和非手术治疗的风险和收益，包括无论治疗选择如何，不愈合率都非常低，不幸的是，受伤后持续疼痛很常见。
方法：本系统综述遵循PRISMA方法。文章来自PubMed/Medline数据库，使用以下搜索词：肩胛骨体或肩胛骨颈或关节内关节盂和骨折。通过搜索所包括的参考文献的参考书目获得了其他文章。如果研究包含有关我们的一个或多个研究目标的临床数据，并且包含具有肩胛骨体的参与者，脖子,和/或至少16岁的关节盂骨折。共35篇论文，共包括822例。对选择的研究进行证据水平评估，并对与当前研究目标有关的数据进行审查。分析了所有文献中发现的肩胛骨骨折病例的结果数据。研究结果包括工会率，重返工作岗位,疼痛,肩部活动范围，力量,功能分数，并记录并发症。
结果：绝大多数肩胛骨骨折继续愈合。大多数患者最终将重返工作岗位。不幸的是，持续的伤后疼痛很常见。与对侧肩膀相比，肩膀的运动范围和力量减少。非手术性关节盂骨折的功能评分最低。Malunion,需要额外的手术，创伤后关节炎是最常见的并发症。
结论：治疗肩胛骨骨折时，骨科医生必须考虑具体的骨折模式，患者的具体目标。应与患者讨论手术和非手术治疗的风险和收益，包括无论治疗选择如何，不愈合率都非常低，不幸的是，受伤后持续疼痛很常见。
