The scapula

Rob Rayward

doi:10.22233/9781910443279.19

The scapula

British Small Animal Veterinary Association , 188 (2016); https://doi.org/10.22233/9781910443279.19

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The scapula

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Author: Rob Rayward
From: BSAVA Manual of Canine and Feline Fracture Repair and Management
Item: Chapter 19, pp 188 - 197
DOI: 10.22233/9781910443279.19
Copyright: © 2016 British Small Animal Veterinary Association
Publication Date: January 2016

Abstract

The scapula is a flat bone that lies in the sagittal plane alongside the thoracic wall. This chapter reviews fractures of the scapular body, fractures of the scapular neck, fractures of the supraglenoid tuberosity. Operative techniques: Fractures of the scapular body; Fractures of the scapular neck; Fractures of the supraglenoid tuberosity.

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Figures

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19.1

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19.1 Lateral aspect of the left scapula. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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19.2

A three-dimensional surface rendered reconstructed CT image showing a comminuted mid-body scapular fracture in a 9-year-old Dachshund. (Courtesy of A Denning) © 2016 British Small Animal Veterinary Association

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19.2 A three-dimensional surface rendered reconstructed CT image showing a comminuted mid-body scapular fracture in a 9-year-old Dachshund. (Courtesy of A Denning)

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19.3

Transverse CT image of the thorax obtained via a bone window, showing a comminuted mid-body scapular fracture (white arrow) in a 9-year-old Dachshund. An alveolar pattern due to lung contusion is also seen within the lung parenchyma, mainly on the ipsilateral side (black arrow) – this would be better visualized with a CT image optimized to show soft tissue pathology. (Courtesy of A Denning) © 2016 British Small Animal Veterinary Association

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19.3 Transverse CT image of the thorax obtained via a bone window, showing a comminuted mid-body scapular fracture (white arrow) in a 9-year-old Dachshund. An alveolar pattern due to lung contusion is also seen within the lung parenchyma, mainly on the ipsilateral side (black arrow) – this would be better visualized with a CT image optimized to show soft tissue pathology. (Courtesy of A Denning)

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19.4

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19.4 Craniocaudal radiograph demonstrating a minimally displaced comminuted mid-body scapular fracture in a 14-month-old Border Collie.

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19.5

A 3-month follow-up mediolateral radiograph demonstrating a locking plate (a 2.7 mm locking compression plate) repair of a scapular neck fracture in a 7-year-old Saluki cross. © 2016 British Small Animal Veterinary Association

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19.5 A 3-month follow-up mediolateral radiograph demonstrating a locking plate (a 2.7 mm locking compression plate) repair of a scapular neck fracture in a 7-year-old Saluki cross.

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19.6

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19.6 Craniocaudal radiograph demonstrating displacement of a scapular neck fracture in a 7-month-old Cocker Spaniel. (Courtesy of P Witte)

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19.7

T-fracture of the scapular neck with involvement of the glenoid cavity. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.7 T-fracture of the scapular neck with involvement of the glenoid cavity. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.8

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19.8 Mediolateral radiograph demonstrating a chronic caudoventral glenoid rim fracture in a 7-month-old Bassett Hound.

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19.9

Mediolateral radiograph demonstrating fracture of the supraglenoid tuberosity associated with a longitudinal scapular body fracture in a 4-year-old Labrador Retriever. © 2016 British Small Animal Veterinary Association

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19.9 Mediolateral radiograph demonstrating fracture of the supraglenoid tuberosity associated with a longitudinal scapular body fracture in a 4-year-old Labrador Retriever.

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19.10

Flexed mediolateral radiograph demonstrating partial avulsion of the supraglenoid tubercle (arrowed) in a 3-month-old Labrador Retriever. Unusually, the tubercle itself has fractured and the caudal portion of the tubercle has remained attached to the scapula. © 2016 British Small Animal Veterinary Association

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19.10 Flexed mediolateral radiograph demonstrating partial avulsion of the supraglenoid tubercle (arrowed) in a 3-month-old Labrador Retriever. Unusually, the tubercle itself has fractured and the caudal portion of the tubercle has remained attached to the scapula.

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19.11

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19.11 Avulsion fracture of the supraglenoid tuberosity. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.12

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19.12 Mediolateral radiograph demonstrating a chronic supraglenoid tuberosity fracture in a 10-month-old German Shepherd Dog.

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19.13

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19.13 Surgical exposure of the scapular body. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.14

Steps in the application of a locking plate to a transverse scapular body fracture. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.14 Steps in the application of a locking plate to a transverse scapular body fracture. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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19.15

Transverse view of the scapula showing ideal screw and plate positioning. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.15 Transverse view of the scapula showing ideal screw and plate positioning. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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19.16

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19.16 Surgical approach to the scapular neck and glenoid. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.17

Steps in repairing a T-fracture of the scapular neck and glenoid. (a) A glide hole is drilled in the caudal fragment. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. (b) Pointed reduction forceps are used to reduce the fracture temporarily whilst a thread hole is drilled and tapped in the cranial fragment. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. (c) Lag screw in position. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.17 Steps in repairing a T-fracture of the scapular neck and glenoid. (a) A glide hole is drilled in the caudal fragment. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. (b) Pointed reduction forceps are used to reduce the fracture temporarily whilst a thread hole is drilled and tapped in the cranial fragment. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. (c) Lag screw in position. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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19.18

T-plate and lag screw repair of a scapular neck and glenoid fracture (T-fracture). Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.18 T-plate and lag screw repair of a scapular neck and glenoid fracture (T-fracture). Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.19

T-plate repair of a non-articular fracture of the scapular neck. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.19 T-plate repair of a non-articular fracture of the scapular neck. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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19.20

Acromial process osteotomy repair. (a) Wire suture. (b) Pin and tension-band wire. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.20 Acromial process osteotomy repair. (a) Wire suture. (b) Pin and tension-band wire. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.

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19.21

(a) Pin and tension-band wire repair of a supraglenoid tuberosity avulsion. (b) Lag screw. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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19.21 (a) Pin and tension-band wire repair of a supraglenoid tuberosity avulsion. (b) Lag screw. Drawn by Vicki Martin Design, Cambridge, UK and reproduced with her permission.