Functional outcome in scapular fracture treatment evaluation with 2-year follow-up in Cipto Mangunkusumo Hospital

Background: Standard treatment of scapular fractures is still controversial. There was no consensus for the best indication in surgical management and therapeutic choice of the scapular fracture. This study aim is to evaluate both radiological characteristics and functional outcomes between patients with scapular fracture treated with conservative and operative management. Methods: We did a case series study of 19 patients with scapular fractures between 2012 and 2017. Nine patients were treated with open reduction internal fixation and 10 patients were treated conservatively. We evaluated radiological outcome using degree of Glenopolar Angle (GPA), angulation, and medialization through anteroposterior, lateral, and scapular Y projection, functional outcome using DASH scores, and complications in 2-year follow-up. Result: The mean patient age was 46.3 ± 18.4 years in the conservative group and 42.7 ± 11.5 years in the operative group. Fracture pattern was classified using Zdravkovic and Damholt (ZD) classification. DASH Score was excellent with 9.5 ± 2.1 points in conservative group and 6.0 ± 2.5 points in operative group with insignificant difference. There was significant difference in GPA and medialization. This is supported by functional outcome of operative group which is higher compared to conservative treatment insignificantly. Conclusion: Operative treatment resulted high functional outcome and minimal complications compared to the conservative group. Operative treatment was recommended for scapular fractures that are displaced more than 9 mm and/or angulated more than 40°. Level of evidence: II, therapeutic study.