Surgical Discussion

Patient positioning:  The patient was positioned in a lateral decubitus position to facilitate access to the posterior aspect of the scapula, with the affected side up. This positioning allowed optimal exposure for the modified Judet approach.

Anatomical surgical approach:  A modified Judet approach was utilized, involving a posterior incision along the scapular spine extending towards the lateral border of the scapula. Subperiosteal dissection was performed to expose the scapular body and glenoid, allowing for direct visualization and manipulation of the fracture fragments.

The surgeon noted that understanding the stable versus unstable segments was crucial for successful reduction. The reduction was achieved by aligning the scapular body to the glenoid neck, counteracting the deforming forces. Fixation was accomplished using plate and screw constructs to maintain stability and promote healing.

Postoperative protocol:   Postoperative rehabilitation included immobilization in a sling for initial comfort, followed by gradual mobilization exercises. Passive range of motion exercises were initiated early, progressing to active-assisted and active range of motion as tolerated. Strengthening exercises were introduced once adequate healing was confirmed radiologically.

Follow up:   Not specified.

Orthopaedic implants used:   Orthopaedic implants used included plate and screw constructs for stabilization of the scapular body and glenoid alignment.