These authors reported their scapular spine stress fracture rate with a reverse total shoulder using an onlay, 145° humeral stem (the Aequalis Ascend Flex stem).
A scapular spine fracture following RSA occurred in 21 patients (4.3%), with a mean time to
diagnosis of 8.6 months (range, 1-34 months). No preoperative factor was found to be a significant predictor of scapular spine fracture. The spine fracture group scored significantly lower than a matched non fracture group on the Constant score and in forward flexion.
diagnosis of 8.6 months (range, 1-34 months). No preoperative factor was found to be a significant predictor of scapular spine fracture. The spine fracture group scored significantly lower than a matched non fracture group on the Constant score and in forward flexion.
12 of the 21 scapular spine fractures occurred at the distal tip of the superior baseplate screw.
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Comment: Scapular spine fracture is another of the complications of reverse total shoulder that are not seen with other types of shoulder arthroplasty. This study indicates that this complication is associated with the weakening of the spine from drill and screw penetration. The risk would seem to be increased by inferior angulation of the base plate and by the use of long drills and screws in the superior hole of the baseplate.
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