Cantore Matteo, Manni Davide, Candela Vittorio, Preziosi Standoli Jacopo, Are Alessandro, Gumina Stefano
Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy.
Sant'Andrea Hospital, Sapienza University, Rome, Italy.
JSES Int. 2025 May 14;9(4):1069-1075. doi: 10.1016/j.jseint.2025.04.012. eCollection 2025 Jul.
Scapular fractures are rare, and few studies in the last 50 years have analyzed their epidemiology in depth. Most of these are dated, show a low sample size, or take into consideration only intra-articular fractures. Furthermore, in none of these studies recent classifications are used. Our aim was to retrospectively analyze a large number of patients to provide detailed epidemiological information about scapular fractures and to classify them with the latest classification system.
Patients admitted for scapular fracture in two trauma centers over a 7-year period were enrolled. A retrospective review of the clinical and radiological data of all patients was performed by two of the authors. Information about age, gender, fracture side, traumatic mechanism, and associated fractures were collected, and all radiological images were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) classification system. Statistical analysis was performed.
A total of 243 patients (172 males and 71 females) with scapular fracture were admitted in the emergency department in a 7-year period. In this study scapular fractures represented 0.9% of all fractures and 6% of shoulder girdle fractures. Males were more often under 75 years of age whereas females were over 75 years. The right side was more involved than the left side. The association between traumatic mechanisms and sex was statistically significant. There were 142 low-energy fractures with 79 fractures involving men (56%) and 63 fractures involving women (44%); 101 injuries were the result of high-energy trauma with 93 cases involving men (92%) and 8 cases involving women (8%). The apophyses were involved in 26 cases (11%; 20 males and 6 females) and the scapular body was involved in 98 cases (40%; 83 males and 15 females). The glenoid fossa was fractured in 119 (49%) patients (69 fractures in men and 50 women). A significant association was found between gender and AO/OTA classification macro groups ( < .001). Females were more frequently affected by type F fractures whereas males more often presented type B fractures.
Scapular fractures occur equally in both genders, although with different age distribution. Female patients are usually older and are mostly affected by low-energy traumas as a fall from standing height. Young males are more often subject to high-energy injuries that occur in road accidents, but with aging they become more prone to fragility fractures.
肩胛骨折较为罕见，过去50年中很少有研究深入分析其流行病学情况。其中大多数研究年代久远，样本量小，或仅考虑关节内骨折。此外，这些研究均未采用最新的分类方法。我们的目的是回顾性分析大量患者，以提供有关肩胛骨折的详细流行病学信息，并采用最新的分类系统对其进行分类。
纳入在7年期间两个创伤中心收治的肩胛骨折患者。两位作者对所有患者的临床和放射学数据进行了回顾性分析。收集了有关年龄、性别、骨折侧、创伤机制和合并骨折的信息，并根据AO/OTA（ Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association，即骨科内固定协会/矫形创伤协会）分类系统对所有放射学图像进行分类。进行了统计分析。
在7年期间，共有243例肩胛骨折患者（172例男性和71例女性）在急诊科就诊。在本研究中，肩胛骨折占所有骨折的0.9%，占肩胛带骨折的6%。男性多为75岁以下，而女性多为75岁以上。右侧受累比左侧更常见。创伤机制与性别之间的关联具有统计学意义。有142例低能量骨折，其中79例发生在男性（56%），63例发生在女性（44%）；101例损伤为高能量创伤所致，其中93例发生在男性（92%），8例发生在女性（8%）。骨骺受累26例（11%；20例男性和6例女性），肩胛体受累98例（40%；83例男性和15例女性）。肩胛盂骨折119例（49%）患者（男性69例，女性50例）。性别与AO/OTA分类大组之间存在显著关联（P<0.001）。女性更常发生F型骨折，而男性更常发生B型骨折。
肩胛骨折在男女中发生率相同，尽管年龄分布不同。女性患者通常年龄较大，主要受低能量创伤影响，如从站立高度跌落。年轻男性更常遭受道路交通事故等高能量损伤，但随着年龄增长，他们更容易发生脆性骨折。
