title: Understanding the concept of medialization in scapula fractures.
abstract: OBJECTIVE
  To determine whether medial displacement of the glenoid with respect to the midline occurs in scapula fractures and the potential impact on fracture reduction technique.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Level I trauma medical center.
  
  
  METHODS
  Seventy patients who sustained scapula fractures from 2004 to 2008 and a comparison group of 47 normal patients without scapula fractures.
  
  
  METHODS
  Computed tomography scans were analyzed from all 70 patients who sustained scapula fractures. Measurements were obtained from the most lateral aspect of the glenoid articular surface to the midline (vertebral spinous process) on both the injured and non-injured sides to assess medial or lateral displacement of the glenoid with respect to the midline. The same measurements were obtained bilaterally for the 47 patients in the comparison group.
  
  
  METHODS
  Medial or lateral displacement of the glenoid with respect to the midline.
  
  
  RESULTS
  Our results showed that for all 70 patients with scapula fractures, the average distance from the glenoid articular surface to the midline was 6.0 mm ± 10.1 greater for the injured shoulder than for the non-injured side (P = 0.0017), indicating lateral displacement of the glenoid. In the comparison group, the mean right-to-left difference from midline was -0.9 mm ± 9.2 (P = 0.4399).
  
  
  CONCLUSIONS
  Our analysis demonstrates that in this group of patients with scapula fractures, there was slight lateral displacement of the glenoid with respect to the midline with significant variability in the degree of medial/lateral displacement. This finding provides evidence that the glenoid fragment retains its anatomic position, and the proximal scapula body fragment may be the fracture component that lateralizes. Recognizing this pattern of displacement may enhance our understanding of scapula fractures and the techniques used during open reduction and internal fixation.
authors: Vanderbilt School of Medicine, Office of Student Affairs, Nashville, TN, USA.
authors: Scott L
authors: SL
authors: Zuckerman
authors: Yanna
authors: Y
authors: Song
authors: William T
authors: WT
authors: Obremskey
mesh_terms: D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D012189:Retrospective Studies; D012540:Scapula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D014057:Tomography, X-Ray Computed