Traumatic Scapula Fracture with Intrathoracic Interposition: A Case Report and Review of Literature.

INTRODUCTION: Scapula fractures are infrequently operated on due to the high union rate and well-preserved motion despite a large degree of angular deformity. Scapula fractures with intrathoracic interposition are rare and typically require open reduction due to an increased risk of pleural injury from the interposed segment. While there are several reports of intrathoracic interposition of scapular fractures requiring open reduction, only one case involved subsequent fragment fixation in an adult.

CASE REPORT: Here, we present a 60-year-old male truck driver who fell from a 3-foot height and sustained a comminuted scapula body fracture with intrathoracic interposition of the lateral column adjacent to the pleural space. Following open reduction and internal fixation of the displaced fragment, the patient had satisfactory pain relief and no respiratory compromise during the acute hospital admission. The patient returned to full work duties without limitations or functional deficits as a heavy laborer.

CONCLUSION: This case report describes a unique case and operative indication for open reduction and internal fixation of scapula fractures. Following open reduction of the interposed fragment, internal fixation should be considered to reduce the risk of further displacement and to optimize post-operative outcomes.