Functional Outcomes of Operative Management of Scapula Fractures in a Geriatric Cohort

Objectives: To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. Design: Retrospective review of prospective database. Setting: A single level-1 teaching trauma center. Patients/Participants: Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older. Intervention: All patients underwent operative treatment of a scapular fracture. Main Outcome Measurements: Disabilities of the Arm, Shoulder, and Hand (DASH), Short-Form Health Survey versions 1 and 2 (SF-36), Range of Motion (ROM), and Strength assessment at final follow-up 1 year or greater. Results: Outcomes were attained on 15/16 patients at a mean follow-up of 40 months (range = 12-114). All fractures were united. Three patients experienced minor perioperative complications (temporary delirium in 2 patients, urinary tract infection in 1). One patient required subsequent removal of an intraarticular screw, and 1 patient required resection of heterotopic ossification and requested implant removal. The mean ROM expressed as a percent of contralateral ROM ranged from 78% to 96%. The mean strength expressed as a percent of contralateral strength ranged from 76% to 92%. The mean DASH score was 8.4. SF-36 scores were comparable with the normal population. All patients returned to activities. Conclusions: Operative treatment for displaced fractures in patients 65 years of age and older is safe and can yield good functional results and return to function. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.