Grammont Award 2018: Scapular fractures in reverse shoulder arthroplasty (Grammont style): prevalence, functional, and radiographic results with minimum 5-year follow-up
These authors sought to determine the rate of scapular fracture (acromial base and spine) after Grammont style reverse total shoulders (RSAs) along with the functional and radiographic results of patients with a minimum 5-year follow-up.
26 of Of 1035 Grammont-style RSAs with minimum 5-year followup sustained a scapular fracture: 19 (10 acromial base and 9 spine fractures).
There were 3 traumatic cases (15.8%) and 13 (68.4%) without antecedent trauma. These 16 patients underwent nonoperative treatment. These fractures occurred mainly in the early postoperative 6 months. Immobilization with an abduction splint frequently resulted in nonunion or malunion. The fractures healed in 8 (4 acromion and 4 spine).
These authors sought to determine the rate of scapular fracture (acromial base and spine) after Grammont style reverse total shoulders (RSAs) along with the functional and radiographic results of patients with a minimum 5-year follow-up.
26 of Of 1035 Grammont-style RSAs with minimum 5-year followup sustained a scapular fracture: 19 (10 acromial base and 9 spine fractures).
There were 3 traumatic cases (15.8%) and 13 (68.4%) without antecedent trauma. These 16 patients underwent nonoperative treatment. These fractures occurred mainly in the early postoperative 6 months. Immobilization with an abduction splint frequently resulted in nonunion or malunion. The fractures healed in 8 (4 acromion and 4 spine).
Final functional outcomes were poor compared with primary RSA without fracture.
Here is another recent article on the topic:
Acromial spine fracture after reverse total shoulder arthroplasty: a systematic review
These authors performed a systematic review of the literature to analyze the occurrence and outcomes of acromial and spine fractures after reverse total shoulder (RSA).
Among 3838 RSAs, 159 acromial fractures were reported, for an overall incidence of 4.14%; the mean time to diagnosis from surgery was 9 months (range, 1.3-24 months).
These authors performed a systematic review of the literature to analyze the occurrence and outcomes of acromial and spine fractures after reverse total shoulder (RSA).
Among 3838 RSAs, 159 acromial fractures were reported, for an overall incidence of 4.14%; the mean time to diagnosis from surgery was 9 months (range, 1.3-24 months).
Regardless of treatment, patients reported inferior function after fracture compared with their function immediately after RSA.
Forward flexion was 95° (range, 30°-110°), abduction was 76° (range, 30°-180°), the Constant score was 63 (range, 59-67.5), and the American Shoulder and Elbow Surgeons score was 57 (range, 7-83); all values were reduced compared with patients without fractures.
This study suggests the occurrence of acromial fractures after RSA is a common event, with a rate of over 4%. These fractures correlate with worse postoperative outcomes regardless of treatment method; open reduction–internal fixation was not shown to be clinically superior despite a limited complication rate.
This study suggests the occurrence of acromial fractures after RSA is a common event, with a rate of over 4%. These fractures correlate with worse postoperative outcomes regardless of treatment method; open reduction–internal fixation was not shown to be clinically superior despite a limited complication rate.
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