Scapular Body Fracture in the Athlete: A Systematic Review

Abstract

Background

Scapular body fractures generally occur as a result of high-energy, direct trauma to the shoulder sustained in automobile accidents. While such mechanisms have been well described, little is known about scapular body fractures sustained during sporting activities.

Questions/Purposes

We sought to systematically review the literature on scapular body fracture sustained during sporting activity, recording rates and mechanisms of injury, management strategies, and return-to-sport times.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of studies conducted between 1985 and 2017. Inclusion criteria were studies examining scapular body fractures sustained during sporting activity, fracture management, and patient outcomes. Exclusion criteria were studies on non-sporting-related fractures and those not reporting fracture management or patient outcomes.

Results

Nine studies encompassing ten cases of scapular body fracture sustained during sporting activity were identified, with acute trauma responsible for 70% of fractures. No patient sustained any associated injuries. Fractures were treated conservatively in 90% of cases, with no reported complications. Mean overall time to return to sport was 2.5 months, while no significant difference in return to sport was appreciated in athletes with acute versus fatigue fractures.

Conclusion

Scapular body fractures in athletes occur primarily from muscle contraction against a resisted force in the upper extremity during contact sports. Unlike non-sporting fractures, these fractures usually involve low-energy mechanisms without associated injury and conservative treatment is usually successful.