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Scapula
Luxation
Trauma/fractures
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Luxation
Signalment
Breeds – Any breed
Gender – No predilection
Age – Any age
Etiology - Trauma. Many cases occur as a result of automobile trauma. Because of this and the fact that the forelimb is affected, careful evaluation of the thoracic structures is important to detect cardiac arrhythmias, pneumothorax, pulmonary edema, or diaphragmatic hernia.
History
A history of trauma is indicated by the owner.
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Clinical Findings
Dogs have a variable degree of lameness. Cases of scapular luxation have an obvious bony protrusion in the dorsal region of the thorax, which is the dorsal border of the scapula.
Diagnostics
Diagnosis is generally obvious on physical examination, but radiographs should be made to assess for any traumatically induced conditions of the thorax and scapula.
Treatment Options
The treatment of choice is generally attachment of the caudal-dorsal border of the scapula to a rib head. A sling may be placed post-operatively to reduce stress on the repair. In some cases, repair of the serratus ventral muscle, which is the muscle holding the scapula to the thorax, may be performed.
Radiograph of fracture of the scapula. The cranial-caudal view is often helpful to evaluate for a scapular fracture
CT of scapula fracture. A CT is very valuable to further define scapular fractures, especially a 3-D reconstruction
Lateral view of scapula fracture with 2 bone plates and screws cranial and caudal to the spine of the scapula. The scapula has very thin bone, so the screws are directed toward the spine/body junction which has the greatest amount of bone for screw purchase
Cranial-caudal view of scapula fracture repair
Trauma/fractures
Signalment
Breeds – Any breed
Gender – No predilection
Age – Any age
Etiology - Trauma. Many cases occur as a result of automobile trauma. Because of this and the fact that the forelimb is affected, careful evaluation of the thoracic structures is important to detect cardiac arrhythmias, pneumothorax, pulmonary edema, or diaphragmatic hernia.
History
A history of trauma is indicated by the owner.
Clinical Findings
Dogs have a variable degree of lameness. In some cases, other traumatic injuries are more obvious, but do not overlook examination of the scapula in cases of trauma. Careful palpation for pain, motion of fragments, especially the spine, acromial process, and glenoid, or crepitus of these structures should be performed.
Diagnostics
Lateral and A-P radiographs must be carefully evaluated for fractures. Fractures of the scapula may be difficult to see, so multiple views or a CT may provide additional information.
Treatment Options
Some fractures of the scapula may be managed conservatively with a Velpeau sling or Spica splint. Surgery is recommended if there is severe displacement of fragments with severe lameness or pain, or if the scapular neck or glenoid are involved in the fracture.
