Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6450
Peer-review started: August 12, 2020
First decision: August 21, 2020
Revised: August 31, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: December 26, 2020
Processing time: 129 Days and 4.7 Hours
Scapular fracture has a low incidence rate, accounting for 0.4%-0.9% of all fractures, and scapular neck fractures are extremely rare, comprising approximately 7%-25% of all scapular fractures. Scapular neck fractures are often studied as case reports mostly accompanied by other injuries, thus leading to confusion. All previous cases of scapular neck fractures are not associated with rotator cuff injuries.
A 62-year-old man was admitted to our emergency department 6 h after his right shoulder and back were impacted by heavy objects. The patient presented chest tightness and shortness of breath. Chest computed tomography (CT) showed pneumohemothorax, multiple rib fractures, and right scapula fractures. Three-dimensional CT reconstruction of the right shoulder joint showed a trans-spinous scapular neck fracture with a glenohumeral joint dislocation. Rotator cuff injury was suspected because the patient had a glenohumeral joint dislocation and was then confirmed by shoulder magnetic resonance imaging. A staged surgery was performed, including open reduction and internal fixation of the right scapula fracture and repairing of rotator cuff by right shoulder arthroscopy. At the 5-mo follow-up, the fracture line was blurred and the shoulder joint function was good.
Fracture of the scapular neck combined with rotator cuff tear is rare and the rotator cuff injury should not be ignored in clinical work. Stable internal fixation combined with secondary arthroscopic repair of rotator cuff tear can achieve good results.
Core Tip: We describe a patient diagnosed with fracture of the scapular neck combined with rotator cuff tear. Scapular fracture has a low incidence rate and scapular neck fractures are extremely rare. Fracture of the scapular neck combined with rotator cuff tear has not been reported previously. Rotator cuff tear should not be ignored in clinical work when treating this type of fracture. Stable internal fixation combined with secondary arthroscopic repair of rotator cuff tear can achieve good results.