title: [Fractures of the scapula and injuries of the acromioclavicular joint. The traumatized shoulder and its sequelae].
abstract: Fractures of the scapula are rare and mainly result from a severe direct trauma. Most fractures may be treated non-operatively, only severely displaced and unstable fractures of the neck and/or the clavicula, unstable intraarticular fractures of the glenoid or open fractures (especially in combination with neurovascular lesions) should be fixed operatively. A dislocated fracture of the clavicula or glenoid should be approached first ventrally. Displaced fractures of the neck and body may also require an open reduction and fixation through a dorsal approach. Careful preoperative planning and anatomical studies are required to prevent intraoperative damage of innervation and vascularization. Cannulated single screws, 1/3 tubular plates or 3.5 LC-DC plates are recommended for the stable fixation of the scapula, whereas a Bosworth screw or a hook plate are helpful to stabilize the lateral clavicula and the acromioclavicular joint. Postoperative treatment: Temporary immobilization in a Gilchrist or Desault bandage for about 3 to 4 days thereafter careful passive and active mobilization.
authors.affiliation: Chirurgische Klinik, Rätisches Kantons- und Regionalspital, Chur.
authors.forename: A
authors.initials: A
authors.lastname: Leutenegger
authors.forename: T
authors.initials: T
authors.lastname: Rüedi
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery; D002968:Clavicle / Q000293:injuries / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D012540:Scapula / Q000293:injuries* / Q000601:surgery
vernacular_title: Frakturen der Scapula und Verletzungen des Acromioclaviculargelenkes. Die traumatisierte Schulter und ihre Spätfolgen.