Significance of Scapular Fracture Existence in Blunt Chest Trauma: A Retrospective Cohort Study.

Autor: Hefny AF; Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, UAE., Mansour NA; Ambulatory Health Services, Abu Dhabi Health Services Company, Abu Dhabi, UAE., Hefny MA; Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Masuadi E; Department of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain, UAE., Al Bahri S; Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, UAE., Elkamhawy AA; Intensive Care Unit, Sheikh Khalifa Medical City, Abu Dhabi, UAE., Saber KS; Emergency Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
Jazyk: angličtina
Zdroj: Surgery research and practice [Surg Res Pract] 2024 May 20; Vol. 2024, pp. 3550087. Date of Electronic Publication: 2024 May 20 (Print Publication: 2024).
DOI: 10.1155/2024/3550087
Abstrakt: Background: Scapular fracture is a rare encounter in blunt trauma patients. The scapula is surrounded by strong groups of muscles offering good protection for the bone. Therefore, a high-energy trauma is needed to cause a scapular fracture. We aim to study scapular fractures and their relation to injury severity and mortality in blunt chest trauma (BCT) patients.
Methods: We retrospectively collected data from all patients with BCT who were admitted to our hospital from December 2014 through January 2017. The injury details of all BCT patients were retrieved from the trauma registry of the hospital and were supplemented by patients' electronic files for missing information. Collected data included demography, mechanism of injury, vital signs, Glasgow Coma Score (GCS) on admission, injured body regions, management, Injury Severity Score (ISS), New Injury Severity Score (NISS), length of hospital stay (LOS), and mortality.
Results: During the study period, 669 patients had BCT. Scapular fracture was present in 29 (4.3%) of the BCT patients. The scapular fracture was missed by chest X-ray in 35.7% of the patients; however, it was accurately diagnosed by computed tomography (CT) scan of the chest. Neck injury was significantly higher in patients with scapular fracture compared with patients without fracture ( p < 0.001). ISS and NISS were significantly higher in patients with scapular fractures compared to other patients without fractures ( p =0.04 and p =0.003 Mann-Whitney U test, respectively). Two patients with scapular fractures died due to severe associated injuries (the overall mortality was 9.6%).
Conclusions: Scapular fracture in BCT patients indicates a high-energy type of trauma. Compared to a chest X-ray, CT scan was more accurate for the diagnosis of scapular fracture. Associated injuries are the main cause of trauma-related mortality rather than the direct effect of the fractured scapula. Particular attention and meticulous evaluation should be paid to head and neck injuries to avoid missing injuries.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2024 Ashraf F. Hefny et al.)
Databáze: MEDLINE
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