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Abstract Objective There are few studies to date reporting on outcomes following reverse total shoulder arthroplasty with cohorts stratified by glenosphere size. The purpose of this study is to investigate the role that glenosphere size has on postoperative outcomes. Methods Patients who underwent reverse TSA between 1987 with minimum of 2.0 years of follow-up were included. Patients were stratified into two cohorts based on glenosphere size of 36mm or 40mm. Patients' range of motion, patient-reported outcomes, and radiographic variables (glenoid preoperative morphology, scapular notching, humeral loosening) were evaluated. Results All measurements of range of motion measurements with the exception of internal rotation saw significant preoperative to postoperative improvements within each cohort. There were no significant differences in postoperative range of motion, ASES, or VAS pain scores across the two cohorts. Overall, forward elevation improved to 134° ± 16° in the 36mm cohort and 133° ± 14° in the 40mm cohort (p = 0.47). External rotation improved to 37° ± 13° for 36mm patients and 35° ± 19° for 40mm patients (p = 0.58). In the 36mm group, internal rotation increased by 1.3 vertebral levels and 2.3 vertebral levels in the 40mm cohort. At final follow-up, the 36mm cohort had a VAS score of 2 ± 2, ASES score of 66 ± 19, and SST score of 6 ± 3. Similarly, the 40mm cohort had a VAS score of 2 ± 3, ASES score of 77 ± 28, and SST score of 9 ± 3. Conclusions Reverse TSA provides sustained improvements in range of motion and shoulder function irrespective of glenosphere size. Level of Evidence III.

Resumo Objetivo Até agora, poucos estudos relataram os desfechos da artroplastia total reversa (ATR) de ombro com coortes estratificadas pelo tamanho da glenosfera. O objetivo deste estudo é investigar o papel do tamanho da glenosfera nos desfechos pós-operatórios. Métodos O estudo incluiu pacientes submetidos à ATR de ombro desde 1987 com acompanhamento mínimo de 2,0 anos. Os pacientes foram estratificados em duas coortes com base no tamanho da glenosfera (36 mm ou 40 mm). A amplitude de movimento, os desfechos relatados pelo paciente e as variáveis radiográficas (morfologia pré-operatória da glenoide, incisura escapular e instabilidade do úmero) foram avaliados. Resultados Todas as medidas de amplitude de movimento, à exceção da rotação interna, melhoraram de forma significativa entre o período pré-operatório e pós-operatório nas duas coortes. Não houve diferenças significativas na amplitude de movimento pós-operatória, pontuação da American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) ou escala visual analógica (EVA) de dor entre as duas coortes. De modo geral, a elevação anterior melhorou para 134° ± 16° na coorte de 36 mm e 133° ± 14° na coorte de 40 mm (p = 0,47). A rotação externa melhorou para 37° ± 13° em pacientes da coorte de 36 mm e 35° ± 19° em pacientes da coorte de 40 mm (p = 0,58). A rotação interna aumentou 1,3 níveis vertebrais na coorte de 36 mm e 2,3 níveis vertebrais na coorte de 40 mm. No último acompanhamento, a coorte de 36 mm apresentou EVA de 2 ± 2, ASES de 66 ± 19 e pontuação do Simple Shoulder Test (SST) de 6 ± 3. Da mesma forma, a coorte de 40 mm teve EVA de 2 ± 3, ASES de 77 ± 28 e SST de 9 ± 3. Conclusões A ATR de ombro causa melhoras sustentadas da amplitude de movimento e função articular independentemente do tamanho da glenosfera. Nível de Evidência III.

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Resumen: Introducción: el bloqueo en el plano del músculo erector de la espina (ESPB, por sus siglas en inglés) es un procedimiento seguro, en teoría menos exigente que las técnicas convencionales de anestesia regional torácica. Se utiliza para el tratamiento del dolor agudo y crónico. En la revisión de la literatura, no se encontraron informes de su uso como una técnica única en el dolor agudo de fractura de escápula. Presentación de caso: se reporta un caso clínico de ESPB como técnica experimental para el control del dolor postoperatorio agudo en fracturas de la escápula con aplicación a nivel T2. Se llevó a cabo postoperatorio con disminución de dolor después de 10 minutos de realizado, con una calificación de cero en la escala análoga del dolor. En este caso el ESPB fue realizado en el postoperatorio inmediato, con lo que se logró una disminución total del dolor a los 10 minutos, con posterior control de dolor a las 36 horas. Conclusión: este caso muestra la efectividad de ESPB como técnica experimental para control de dolor postoperatorio en fractura de escápula.

Abstract: Introduction: the erector spine plane block (ESPB) is a safe procedure, technically is less demanding than conventional thoracic regional anesthesia techniques. It is used for the treatment of acute and chronic pain. In the literature review, no reports of its use as a single technique in the acute pain of scapula fracture were found. Case presentation: ESPB is reported in a case as an experimental technique for controlling acute postoperative pain in scapula fractures with an application at the T2 level. It was performed postoperatively with a decrease in pain after 10 minutes and a score of zero on the analog pain scale. In this case, the ESPB was performed in the immediate postoperative period, achieving a total decrease in pain at 10 minutes, with subsequent pain control at 36 hours. Conclusion: this case shows the effectiveness of ESPB as an experimental technique for postoperative pain control in scapula fractures.

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SUMMARY: The aim of this study is to measure the significant parameters on scapula at computed tomography images and to determine the effects of these parameters for sex determination. The second aim is to find the most effective single and combined parameters to use for sex determination using scapula in Turkish population. In this study, morphometric measurements of scapula on the computed tomography images of 60 male and 60 females were evaluated and their impacts on sex determination were examined via stepwise logistic regression analysis. 10 parameters and 6 indexes calculated via using these parameters were measured. Scapular breadth of the right scapulae (86.7%), maximum scapular length of the left scapulae (85%), scapular breadth of all scapulae (80%) were found to be the most effective single parameters. Combination of the scapular breadth and maximum scapular length were 85%, 90%, 86.7% effective in sex determination on the right scapulae, on the left scapulae and on all of the scapulae, respectively. We believe that the results of this study will contribute to sex determination studies using the scapula in Turkish population for anatomist, anthropologist and forensic scientists.

El objetivo de este estudio fue medir los parámetros significativos en la escápula en imágenes de tomografía computarizada y determinar los efectos de estos parámetros para la determinación del sexo. El segundo objetivo fue encontrar los parámetros individuales y combinados más efectivos para determinar el sexo utilizando la escápula en la población turca. Se evaluaron las medidas morfométricas de la escápula en las imágenes de tomografía computarizada de 60 hombres y 60 mujeres y se examinó su impacto en la determinación del sexo mediante un análisis de regresión logística paso a paso. Se midieron 10 parámetros y 6 índices calculados mediante el uso de estos parámetros. El ancho escapular de la escápula derecha (86,7 %), la longitud escapular máxima de la escápula izquierda (85 %), el ancho escapular de todas las escápulas (80 %) resultaron ser los parámetros individuales más efectivos. La combinación del ancho escapular y la longitud máxima escapular fueron 85%, 90%, 86,7% efectivas en la determinación del sexo en la escápula derecha, en la escápula izquierda y en todas las escápulas, respectivamente. Creemos que los resultados de este estudio contribuirán a los estudios de determinación de sexo utilizando la escápula en la población turca para anatomistas, antropólogos y científicos forenses.

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Introducción: Las fracturas de escápula tienen una baja frecuencia, se presentan mayoritariamente en población joven tras traumatismos de alta energía. Su tratamiento historicamente ha sido conservador, sin embargo, el tratamiento quirúrgico ha demostrado mejores resultados funcionales en pacientes seleccionados, siendo la indicación quirúrgica aún controversial. La literatura sobre los pacientes tratados de forma quirúrgica es escasa. Objetico general: Caracterizar a los pacientes operados por fractura de escapula en Hospital Traumatológico de Concepción durante los años 2019-2022. Materiales y métodos: Estudio descriptivo que incluye a pacientes operados por fractura de escápula en el Hospital Traumatológico de Concepción durante los años 2019 al 2022, considerando las variables sexo, edad, lateralidad, mecanismo de lesión y lesiones asociadas. Resultados: Se estudiaron 20 pacientes de los cuales 90% fueron hombres, registrándose un promedio de edad de 41 años, sin diferencias significativas en su lateralidad. Los principales mecanismos de lesión fueron accidentes de tránsito y caídas de altura, existiendo lesiones asociadas sólo en 45% de los casos. Conclusión: Las fracturas de escápula tienen alto impacto en la funcionalidad de la extremidad afectada, por lo que su tratamiento hoy en día esta evolucionando hacia uno quirúrgico en pacientes seleccionados, con el fin de obtener mejores resultados funcionales. Los pacientes operados son mayoritariamente adultos de edad media de sexo masculino, con fracturas secundarias a traumatismos de alta energía y presencia de lesiones asociadas de baja morbimortalidad.

Introduction: Scapula fractures have a low frequency. They occur mainly in the young population after high-energy trauma. Its treatment has historically been conservative; however, surgical treatment has shown better functional results in selected patients, the surgical indication being still controversial. The literature on patients treated surgically is scarce. General Objective: Characterize the patients operated on for scapular fracture at the Hospital Traumatológico de Concepción during the years 2019-2022. Materials and methods: Descriptive study that includes patients operated on for scapula fracture at the Concepción Trauma Hospital during the years 2019 to 2022, considering the variables sex, age, laterality, mechanism of injury and associated injuries. Results: Twenty patients were studied, of whom 90% were men, recording an average age of 41 years, with right scapula fracture being slightly more frequent than left. The main mechanisms of injury were traffic accidents and falls from a height, with associated injuries only in 45% of the cases. Conclusion: Scapula fractures have a high impact on the functionality of the affected limb, so their treatment today is evolving towards surgery in selected patients, in order to obtain better functional results. The patients operated on are mostly middle-aged male adults, with fractures secondary to high-energy trauma and the presence of associated lesions with low morbidity and mortality.

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Antecedentes: El handball es un deporte "overhead" que expone al hombro a demandas elevadas de carga durante la práctica, lo que puede llevar a esta articulación a sufrir adaptaciones específicas. La comprensión de estas adaptaciones es importante y puede ayudar a los clínicos a crear protocolos de prevención y a desarrollar programas de condicionamiento y rehabilitación para esta población. Objetivos: Generar un perfil descriptivo de:1) movimiento escapular durante la elevación y descenso de la extremidad superior en el plano escapular, 2) distancia acromiohumeral y 3) rango de movimiento y fuerza rotacional glenohumeral en deportistas femeninas de handball de élite. Métodos: Se realizo un estudio transversal observacional y descriptivo en 23 jugadoras (Edad = 22±4.3 años; Años de practica 9.7±3.5) de handball de élite, libres de dolor. Se valoró el movimiento escapular bilateral durante la elevación y el descenso del brazo, la distancia acromiohumeral durante la abducción activa y pasiva, y el rango de movimiento articular y la fuerza rotacional GH en rotación interna y externa. Se describen estas variables, comparándolas entre ambos brazos, y entre los grupos formados en función del déficit de rotación interna GH. Resultados: No se detectaron diferencias significativas en el movimiento escapular 3D ni en la distancia acromiohumeral entre los brazos. Se observó una disminución del rango de rotación interna (Diferencia Media (DM)= -11.09°; Intervalo Confianza 95% (IC)= -17.70,-4.47) y un incremento del rango de rotación externa (DM= 12.82°; IC= 6.07°,19.58°) en el hombro dominante. El torque rotacional GH en rotación externa fue mayor (DM= 0.36 Nm/kg; IC=-0.008 Nm/kg, -0.81Nm/kg) en el hombro dominante. Las participantes con déficit de rotación interna mostraron mayores rangos de rotación superior y tilt posterior escapular durante la elevación, mayor distancia acromiohumeral en reposo y mayor disminución de esta durante la elevación de la extremidad Conclusión: Los resultados sugieren que no existen diferencias en el movimiento escapular durante la elevación y descenso de la extremidad superior, ni en la distancia acromiohumeral en las diferentes posiciones de elevación GH activa y pasiva entre el brazo dominante y no dominante de las deportistas femeninas de handball de élite. Los hallazgos indican que el brazo lanzador de estas deportistas presenta diferencias en el rango rotacional y en la fuerza, que podrían representar un factor de riesgo lesional, siendo detectables en el ambiente clínico. Las deportistas que presentan GIRD, muestran mayor movimiento escapular 3D durante la elevación, mayor DAH en reposo y mayor disminución de esta durante la elevación de la ES

Background: Handball is an overhead sport that exposes the shoulder to high demands of load during the practice, which may lead this joint to sport-specific adaptions. Understanding these adaptions is important and may help clinicians to create preventive protocols and further develop conditioning and rehabilitation program to this population. Objectives: To generate a descriptive profile of:1) scapular motion during upper extremity raising and lowering along the scapular plane, 2) acromiohumeral distance, and 3) GH rotational range of motion and rotational strength in elite female handball athletes. Methods: This is observational and descriptive cross-sectional study. Twenty-three (22±4.3 years and 9.7±3.5 years of practice) pain free elite female handball players were assessed. Outcome measures included bilateral 3D scapular movement during raising and lowering of the arm, acromiohumeral distance during passive and active abduction, GH range of motion of internal and external rotation, and strength of the internal and external rotators. These variables were described by comparing them between both arms, and among the groups according to the GH internal rotation deficit. Results: No significant differences were detected in 3D scapular motion or acromiohumeral distance between the arms. A decrease in internal rotation range of motion (Mean Difference (MD) =-11.09°;95% Confidence Interval (CI)= -17.70°, -4.47°) and an increase in external rotation range of motion (MD= 12.82°; CI=6.07°, 19.58°) and in GH rotational torque in external rotation (MD=0.36 Nm/kg; CI=-0.008Nm/kg, -0.81Nm/kg) were observed in the dominant shoulder. Participants with internal rotation deficit showed greater ranges of superior rotation and scapular posterior tilt during raising, greater acromiohumeral distance at rest and greater decrease of this during limb elevation. Conclusion: The findings suggest there are no differences in in the scapular movement during upper extremity raising and lowering along the scapular plane, nor in the acromiohumeral distance during passive and active GH between the dominant and non-dominant arm of elite female handball athletes. The findings indicate that there are differences in rotational range of motion and strength between both arms, which could represent an injury risk factor, being detectable in the clinical sports environment. Participants with internal rotation deficit showed greater scapular 3D movement, greater DAH at rest and greater decrease of it during arm elevation

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Se presenta el caso clínico de un paciente de 47 años de edad, quien acudió al Servicio de Ortopedia y Traumatología del Hospital Docente Clinicoquirúrgico Joaquín Albarrán de La Habana por presentar dolor en el cuello irradiado al miembro superior izquierdo. En la exploración física se destacó atrofia de los músculos romboides de la escápula izquierda y deformidad alar, acentuada durante la maniobra. Se realizó radiografía y electromiografía; en la primera, se observó costilla cervical supernumeraria izquierda y, en la segunda, lesión del nervio dorsal escapular, por lo cual se diagnosticó síndrome del nervio dorsal escapular secundario a síndrome del escaleno anterior. Se indicó tratamiento fisioterapéutico y el paciente evolucionó satisfactoriamente.

The case report of a 47 years patient is presented, who went to the Orthopedics and Traumatology Service of Joaquín Albarrán Teaching Clinical Surgical Hospital in Havana due to a pain in the neck irradiated to the left superior member. In the physical exploration atrophy of the left scapula romboid muscles and alar deformity were notable, accented during the maneuver. Radiography and electromyography were carried out; in the first one, left supernumerary cervical rib was observed and, in the second one, dorsalscapular nerve leison, reason why the secondary dorsal scapular nerve syndrome to anterior scalene syndrome was diagnosed. Physiotherapeutic treatment was indicated and the patient had a favorable clinical course.

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SUMMARY: As natural disasters or crimes, precise postmortem identification is needed especially in case of unknown human remains. The aim of the study is to assess sexual dimorphism by formulating new multivariate equations based on scapular and clavicular parameters for a modern Thai population. Eight left scapular and six left clavicular parameters were measured from 278 individuals (124 males and 124 females for training group; and 15 males and 15 females for test group) of a modern Thai population with age ranges from 19 to 101 years. All scapular and clavicular parameters were sexually dimorphic. Direct and stepwise multivariate discriminant function analysis was performed to generate models. Three direct multivariate discriminant functions showed accuracy rates from 91.1c to 92.3 % (cross-validated range from 90.3 % to 91.5 %). Similarly, three stepwise multivariate discriminant functions showed accuracy rates from 90.7 % to 92.7 % (cross-validated range from 90.7 % to 92.7 %). Moreover, the test group showed 86.67 % to 100 % of sex determination accuracy in six discriminant functions. As recommendation for sex determination by using combination of the scapular and clavicular parameters yields statistically high accuracy for sex determination. Therefore, the accuracies of these multivariate discriminant function equations obtained from scapula and clavicle can be applied for forensic sex determination, especially in modern Thais.

RESUMEN: En casos de desastres naturales o crímenes se requiere una identificación post mortem precisa, especialmente en el caso de restos humanos desconocidos. El objetivo de este estudio fue evaluar el dimorfismo sexual mediante nuevas ecuaciones multivariadas basadas en parámetros escapulares y claviculares para una población tailandesa moderna. Se midieron ocho parámetros escapulares izquierdos y seis claviculares izquierdos de 278 individuos (124 hombres y 124 mujeres para el grupo de entrenamiento; y 15 hombres y 15 mujeres para el grupo de prueba) de una población tailandesa moderna con rangos de edad de 19 a 101 años. Todos los parámetros escapulares y claviculares presentaban dimorfismo sexual. Se realizaron análisis de funciones discriminantes multivariadas directas paso a paso para generar modelos. Tres funciones discriminantes multivariadas directas mostraron tasas de precisión de 91,1 % a 92,3 % (rango de validación cruzada de 90,3 % a 91,5 %). De manera similar, tres funciones discriminantes multivariadas mostraron tasas de precisión de 90,7 % a 92,7 % (rango de validación cruzada de 90,7 % a 92,7 %). Además, el grupo de prueba mostró del 86,67 % al 100 % de precisión en la determinación del sexo en seis funciones discriminantes. Como recomendación para la determinación del sexo mediante el uso de la combinación de los parámetros escapulares y claviculares, se obtiene una precisión estadísticamente alta para la determinación del sexo. Por lo tanto, las precisiones de estas ecuaciones de funciones discriminantes multivariadas obtenidas de la escápula y la clavícula se pueden aplicar para la determinación forense del sexo, especialmente en los tailandeses modernos.

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SUMMARY: The aim of this study is to contribute to sex determination studies from the scapula in the Turkish population and compare with previous studies. This study was performed with 200 scapulae (100 males and 100 females). The age range of the patients was between 18-93 years old. Computed tomography scans were used and length of glenoid cavity (LGC), breadth of glenoid cavity (BGC), depth of glenoid cavity (DGC), perimeter (PM) and volume (VL) were measured. Randomly selected 20 scapulae were measured three times for examine the intra-rater reliability from those measurements. Gender logistic regression analysis was conducted to find the significant variables at sex determination from the scapula. The most effective parameter in determining sex from scapula was found to be VL (88.5%). The effects of LGC, PM, BGC and DGC at sex determination from scapula were found to be 83%, 82.5%, 79.5%, 66%, respectively. The combination of VL and PM (89.5%) was found to be the most effective combination at sex determination from the scapula. The intraclass correlation values of all measurements were found to be at high reliability. According to the literature, PM and DGC along with the VL in Turkish population, were not used previously for sex determination from the scapula. A combination of the VL and PM was found to be the most effective parameters at sex determination from scapula in the Turkish population. There are few studies on the sex determination from scapula in the Turkish population. This study will guide anthropologists, forensic scientists and anatomists at sex determination studies from scapula and surgeons by morphometrically in clinical situations related to the scapula.

RESUMEN: El objetivo de este estudio fue contribuir a la determinación del sexo a partir de la escápula en la población turca y comparar con estudios previos. Esta investigación se realizó con 200 escápulas (100 hombres y 100 mujeres). El rango de edad de los pacientes estaba entre de 18 años y 93 años. Escaner de tomografía computada se usó para medir en la cavidad glenoidea los siguientes parámetros: longitud (LCG), ancho (ACG), profundidad (PCG), perímetro (PG) y volumen (VCG). Se midieron 20 escápulas seleccionadas tres veces al azar para examinar la confiabilidad intraevaluador de estas mediciones. Se realizó un análisis de regresión logística de género para encontrar las variables significativas en la determinación del sexo a partir de la escápula. El parámetro más eficaz para determinar el sexo a partir de la escápula resultó ser VCG (88,5%). Los efectos de LCG, PG, ACG y PCG en la determinación del sexo a partir de la escápula fueron del 83 %, 82,5 %, 79,5 % y 66 %, respectivamente. La combinación de VCG y PG (89,5%) resultó ser la combinación más efectiva en la determinación del sexo a partir de la escápula. Se encontró que los valores de correlación intraclase de todas las mediciones tenían una alta confiabilidad. De acuerdo con la literatura, PG y PCG junto con el VCG en la población turca, no se han utilizado previamente para la determinación del sexo a partir de la escápula. Se determinó que una combinación de VCG y PG son los parámetros más efectivos en la determinación del sexo a partir de la escápula. Existe escasa información sobre la determinación del sexo a partir de la escápula en la población turca. Este estudio guiará a los antropólogos, forenses y anatomistas en los estudios de determinación del sexo de la escápula y sera útil para los cirujanos en situaciones clínicas relacionadas con la escápula.

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OBJETIVO: Avaliar a confiabilidade inter e intraexaminador, na utilização de instrumentos de avaliação da retração de cintura escapular em crianças internadas em uma unidade de cuidados intermediários neonatal. MATERIAL E MÉTODOS: Estudo quantitativo, transversal e observacional, realizado com recém-nascidos e lactentes que necessitaram de internamento em uma unidade de cuidados intermediários neonatal. A coleta de dados ocorreu de outubro de 2019 a fevereiro de 2020. Para avaliação da retração da cintura escapular foi utilizado um protocolo de inspeção biomecânica elaborado pelas pesquisadoras, que possibilitou a realização de medidas (em centímetros) das bordas mediais superiores e inferiores, direita e esquerda, até a coluna vertebral, com a cabeça em rotação para a direita e para a esquerda, e o sinal do cachecol. As avaliações foram realizadas sempre pelos mesmos avaliadores. Para estimar a confiabilidade inter e intraexaminador do protocolo de inspeção biomecânica e sinal do cachecol, foi utilizado o Índice de Kappa e para as medidas do posicionamento das escápulas, o Coeficiente de Correlação Intraclasse. RESULTADOS: O protocolo de inspeção biomecânica dos sinais sugestivos de retração de cintura escapular demostrou concordância leve a moderada interexaminadores, e substancial a quase perfeita intraexaminador. A concordância interexaminadores obtida no sinal do cachecol foi leve a moderada, e quase perfeita intraexaminador. O posicionamento das escápulas apresentou concordância interexaminadores considerada como boa, e concordância excelente intraexaminador. CONCLUSÃO: A avaliação de sinais sugestivos de retração de cintura escapular, em recém-nascidos e lactentes, apresenta baixos índices confiabilidade interexaminadores e altíssima confiabilidade intraexaminador

OBJECTIVE: To evaluate inter and intra-examiner reliability in the use of instruments to assess shoulder girdle retraction in children hospitalized in a neonatal intermediate care unit. METHODS: Quantitative, cross-sectional and observational study carried out with newborns and infants who required hospitalization in a neonatal intermediate care unit. Data collection took place from October 2019 to February 2020. To evaluate shoulder girdle retraction, a biomechanical inspection protocol developed by the researchers was used, which made it possible to measure (in centimeters) from the upper and lower medial edges, right and left, to the spine, with the head in rotation to the right and left, and the scarf sign. The evaluations were always carried out by the same evaluators. To estimate inter and intra-examiner reliability of the biomechanical inspection protocol and scarf signal, the Kappa Index was used and, for measurements of scapular positioning, the Intraclass Correlation Coefficient. RESULTS: The biomechanical inspection protocol for suggestive signs of scapular girdle retraction showed mild to moderate inter-examiner agreement and substantial to almost perfect intra-examiner agreement. The intra-examiner agreement obtained in the scarf sign was mild to moderate and almost perfect intra-examiner. The positioning of the scapulae showed good inter-examiner agreement and excellent intra-examiner agreement. CONCLUSION: The evaluation of suggestive signs of scapular girdle retraction in newborns and infants has low inter-examiner reliability and very high intra-examiner reliability.

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ABSTRACT Introduction: Scapular fractures are rare injuries and are often associated with high-energy trauma, with joint fractures accounting for only 15% of all scapular fractures. Surgical treatment is indicated for fractures with large deviations and with joint instability. Objective: This study evaluates the clinical and functional results after surgical treatment of scapular fractures. Methods: Eight patients with scapular fractures were surgically treated between 2013 and 2019. For indication for surgical treatment, mediolateral deviations, glenopolar angle, angular deviations and joint deviations greater than 4 mm were taken into account. Radiographic results of consolidation, range of motion, functional score and visual analogue pain scale were obtained. Results: In the mean follow-up of twenty-nine months (13-40 months), all patients presented fracture consolidation. The mean UCLA score was 29 points (with 75% good results and 25% moderate results). Regarding the range of motion, the mean elevation was 146° (ranging from 110° to 60°), lateral rotation of 62° (36-80°) and medial rotation at the level of T7 (T6-T10). The final VAS mean was 2.3. All patients returned to the pre-injury level at work. Conclusion: In this series of cases, surgical treatment of scapular articular fractures provided satisfactory results with low rates of complications, showing to be an option in selected cases of deviated fractures. Level of Evidence IV, Case Series.

RESUMO Introdução: As fraturas de escápula são lesões raras e muitas vezes associadas a traumas de alta energia, sendo que as fraturas articulares correspondem a apenas 15% de todas fraturas escapulares. O tratamento cirúrgico é indicado para fraturas com grandes desvios e com instabilidade articular. Objetivo: Avaliar os resultados clínicos e funcionais após o tratamento cirúrgico das fraturas de escápula. Métodos: Oito pacientes com fraturas da escápula foram tratados cirurgicamente entre o período de 2013 e 2019. Para indicação do tratamento cirúrgico, levou-se em consideração os desvios mediolaterais, ângulo glenopolar, desvios angulares e desvio articular maior que 4 mm. Resultados radiográficos de consolidação, arco de movimento, escore funcional e escala visual analógica de dor foram obtidos. Resultados: No seguimento médio de 29 meses (13-40 meses), todos os pacientes apresentaram consolidação da fratura. A média do escore UCLA foi de 29 pontos (sendo 75% de resultados bons e 25% de resultados moderados). Com relação ao arco de movimento, a elevação média foi de 146° (variando de 110° a 160°), rotação lateral de 62° (36-80°) e rotação medial no nível de T7 (T6-T10). A média final do EVA foi de 2,3. Todos os pacientes retornaram ao nível pré-lesão de trabalho. Conclusão: Nesta série de casos, o tratamento cirúrgico das fraturas da escápula com envolvimento articular proporcionou resultados satisfatórios com baixa taxas de complicações, mostrando ser uma opção em casos selecionados de fraturas desviadas. Nível de Evidência IV, Série de Casos.