Scapular fractures and concomitant injuries.
OBJECTIVE
The association of scapular fractures with other life-threatening injuries including blunt thoracic aortic injury is widely recognized. Few studies have investigated this presumed association. In this study, we investigated the incidence of significant associated injuries with scapular fracture and their outcomes.


METHODS
A retrospective study was conducted from 2005 to 2009 in a level I trauma center in Thailand. All blunt trauma patients were identified. Patients?demographics, injury mechanism, associated injuries, Injury Severity Score (ISS), and survival outcomes were recorded. The management of associated injuries with scapular fracture was reviewed, and the risk factors for mortality were identified.


RESULTS
Among the 7 345 trauma patients admitted, scapular fractures occurred in 84 cases (1.1%). The mean age was (37.98+/-15.21) years. Motorcycle crash was the most frequent mechanism of injury, occurring in 51 cases (60.7%). Seventy-four patients (88.1%) suffering from scapular fractures had associated injuries: 5 (6.0%) had significant chest injuries, but none of them had blunt thoracic aortic injury. Two patients (2.4%) with scapular fractures died. Factors determining the likelihood of mortality were: (1) ISS larger than 25 (LR equal to 8.5, P less than 0.05); (2) significant associated chest injury (AIS larger than 3, LR equal to 5.3, P less than 0.05) and (3) significant associated abdominal injury (AIS larger than 3, LR equal to 5.3, P larger than 0.05).


CONCLUSIONS
A blunt scapular fracture may not accompany a blunt thoracic aortic injury but it is strongly related to other injuries like chest injury, extremity injury, head injury, etc. If a scapular fracture is found with a high ISS score, high chest or abdomen AIS score, the patient would have a high risk of mortality.
Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Osaree
O
Akaraborworn
Burapat
B
Sangthong
Komet
K
Thongkhao
Prattana
P
Chiniramol
Khanitta
K
Kaewsaengrueang
D050723:Fractures, Bone; D006801:Humans; D015601:Injury Severity Score; D012189:Retrospective Studies; D013898:Thoracic Injuries; D014949:Wounds, Nonpenetrating / Q000453:epidemiology