(ii) Fractures of the scapula

Fractures of the scapula and its glenoid fossa are uncommon and, when they do occur, are frequently associated with other injuries, particularly thoracic injuries. Traditional management is nonoperative, with pain relief and mobilization according to symptoms, but there is increasing evidence that open reduction and internal fixation may have a part to play. This is most true for marginal glenoid fractures associated with ongoing shoulder instability, but strong arguments can also be made for displaced intra-articular fractures of the glenoid and fractures of the glenoid neck with significant medialization or with an associated clavicle fracture. This article reviews the management of patients with scapular and glenoid fractures and discusses the practical aspects of surgical management.