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A severe shoulder fracture


I’m the victim of a traffic accident that resulted in a severe shoulder injury. The shoulder joint (lat. glenoid) had multiple fractures and the shoulder blade (lat. corpus scapula) was comminuted. Here I describe a summary of my medical treatments. For a more extensive description see the case report: Scapula reconstruction after malunion of the corpus scapula.
First shoulder operation, orif of the intra articular scapula fracture

X-Ray AP, scapula fracture at the day of the accident.
X-Ray AP, scapula fracture at the day of the accident.

After the life threatening injuries were treated, I had my first shoulder operation. The fractures of the scapula neck and glenoid were fixated and the comminuted scapula was treated conservatively, which means that I had my arm in a sling for about 6 weeks. During that time the bone pieces of the scapula grew together in the position they were in. This resulted in a deformation (malunion) of the scapula. The deformation had a negative influence on the functioning of the rotator cuff muscles (muscles that keep the head of the upper arm in the glenoid). As a result my range of motion was limited and the strength of the arm was poor. The deformity of the scapula also caused pain in the shoulder region.
Second shoulder operation, removal of the osteosynthese material

Because two screws ended up in the glenoid, I had a second operation to have all the osteosynthese material (plates and screws) removed.
3D image PA, scapula fracture after second operation.
3D image PA, scapula fracture after second operation.
Third shoulder operation, placement of a lateral meniscus allograft

The shoulder joint fracture limited the range of motion considerably. The cartilage of the glenoid (lat. labrum) was damaged which caused the distance between the humerus head and the glenoid to be very narrow. When moving the arm, the head of the upper arm got jammed in the shoulder joint. Placing a donor meniscus (lat. lateral meniscus allograft) in the glenoid, the distance of the humerus head and glenoid was increased. This procedure is used for people younger than 60 years with arthritis in the shoulder joint to reduce complaints. With this procedure no shoulder prosthesis needs to be placed.
Fourth shoulder operation, a corpus scapula reconstruction

3D image PA, scapula fracture after fourth operation.
3D image PA, scapula fracture after fourth operation.

The shoulder blade injury remained. Because injuries of the shoulder blade are uncommon, it is hard to find a good trauma surgeon with enough practice in that field. In America I found a surgeon who was able to reconstruct the corpus scapula to its original shape. Dr. Peter A. Cole developed procedures and methods to restore broken shoulder blades. I haven’t found surgeons outside America who are able to perform similar operations. If you suffer from a severe scapula fracture I highly recommend treatment by Dr. Peter A. Cole. Medical treatment in America is excellent but keep in mind that surgery in America is also quite expensive. My range of motion and strength has improved significantly.

Dr. Peter A. Cole is chief of orthopedic surgery of the Regions Hospital. The address is:
Regions Hospital
640 Jackson Street
St. Paul, MN 55101
Tel (01) 651-254-3456

For more information about Dr. Cole his achievements see: The Scapula Institute
X-Ray AP, scapula fracture at the day of the accident.X-Ray AP, scapula fracture at the day of the accident.
3D image PA, scapula fracture after second operation.3D image PA, scapula fracture after second operation.
3D image PA, scapula fracture after fourth operation.3D image PA, scapula fracture after fourth operation.