title: Scapular spine stress fractures: To fix or not to fix, our experience in a patient with bilateral fractures and review of the literature.
abstract: We report a case of bilateral scapular spine stress fracture, treated conservatively on one side and operatively on the other side. Besides, we performed a literature review to establish management options. A 61-year-old right-handed gentleman came to our clinic with acute on chronic deterioration of shoulder pain and loss of arm function. Clinical assessment and investigations revealed long-standing bilateral rotator cuff tear and scapular spine stress fractures. The fracture on the right side united with conservative management for 2 months. However, his left side remained symptomatic with pain, abnormal mobility and no radiological evidence of union. The fracture progressed to union after fixation and bone grafting. At the final follow-up at 2 years, the patient was asymptomatic with regards to the fractures with Oxford Shoulder Score (OSS)-30 and Disabilities of the Arm, Shoulder and Hand (DASH)-30.8. Fracture union either by conservative or operative treatment is associated with good functional outcome and is supported by our review.
authors.affiliation: Department of Orthopaedic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
authors.forename: Karuppaiah
authors.initials: K
authors.lastname: Karthik
authors.affiliation: Department of Orthopaedic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
authors.forename: Jason
authors.initials: J
authors.lastname: Lau
authors.affiliation: Department of Orthopaedic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
authors.forename: Joydeep
authors.initials: J
authors.lastname: Sinha
authors.affiliation: Department of Orthopaedic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
authors.forename: Adel
authors.initials: A
authors.lastname: Tavakkolizadeh
keywords: Cuff tear arthropathy; scapula fracture; scapula spine stress fracture; stress fracture