Fractures of the scapula surgical neck: outcome after conservative treatment in 13 cases

Background: Conservative treatment of fractures of the scapular neck does not uniformly lead to a success. The purpose of this retrospective study was to analyze the occurrence of glenoid displacement in conservatively treated patients with a scapular neck fracture without concomitant shoulder girdle injury in relation with the clinical outcome. Methods: Between 1991 and 2001, 177 patients with a fracture of the scapula were treated in two Dutch clinics. Twenty-four patients sustained a scapular neck fracture, who all, with the exception of one, were treated non-operatively. At follow-up, 13 patients had a functional evaluation and were assessed clinically at an average of 5.5 years after the injury. Results: All fractures healed uneventfully. At final radiographic evaluation, four patients were found with significant translational displacement of fracture fragments (>1 cm); however, no angular displacement of the glenoid was found (no GPA<20°). The functional outcome of the 13 patients was excellent (Constant score: 90). No correlation was found between functional outcome and malunion. There was no significant difference between the SF-36 scores in the follow-up group and the scores for age-matched controls in the general population. Conclusions: Non-operative treatment of a surgical neck fracture of the scapula in absence of an ipsilateral shoulder injury and associated permanent neurological impairment leads to a good to excellent functional outcome, with or without significant translational displacement.